Background Non-alcoholic fatty liver disease (NAFLD) is an emerging extraintestinal manifestation (EIM) of Crohn’s disease (CD). We aimed to investigate the prevalence and comorbid predictors of NAFLD in patients with CD. Methods We conducted a nationwide retrospective cohort study to determine the prevalence, characteristics, comorbidities, and hospitalization outcomes associated with NAFLD in patients with CD. Comparison between groups was performed by Mann-Whitney test for continuous variables and Chi-square test for categorical variables. We performed a binary logistic regression analysis for predictors of NAFLD among patients with CD. Results We extracted 215,049 index hospital discharges with CD; 2.4% had NAFLD. CD patients, with NAFLD, had increased length of stay (4 days; interquartile range (IQR): 2 - 6 vs. 3; IQR: 2 - 6, P < 0.01), and increased median total charges ($32,305.5; IQR: $18,600 - $61,599 vs. $30,782; IQR: $16,847 - $58,667, P < 0.01), compared to CD patients without NAFLD. Non-alcoholic steatohepatitis (NASH) was found to be independently associated with increased mortality (odds ratio (OR): 1.7; 95% confidence interval (CI): 1.1 - 2.6, P = 0.03) and a higher odd for all-cause 30-day non-elective readmission (OR: 1.6: 95% CI: 1.3 - 1.9, P < 0.001). Factors independently associated with NAFLD in patients with CD included portal hypertension (OR: 5.347; 95% CI: 4.604 - 6.211, P < 0.001), vitamin A deficiency (OR: 9.89; 95% CI: 4.49 - 21.76, P < 0.001) and vitamin B12 deficiency (OR: 1.56; 95% CI: 1.098 - 2.209, P = 0.013). Conclusions NAFLD is associated with worse hospitalization outcomes in patients with CD. Study findings suggest the need for early identification and effective management of NAFLD predictors to reduce complications.

Background There are few studies to evaluate the association between iron deficiency anemia (IDA) and Crohn’s disease (CD). We examined this association in a USA-based cohort of patients with CD. Methods We queried the Nationwide Readmission Databases 2018 using the International Classification of Disease, 10th Revision, and Clinical Modification (ICD-10-CM) codes to identify all adult patients admitted with a diagnosis of CD. Primary outcomes were the prevalence of IDA among patients with CD. Secondary outcomes included inpatient mortality, the length of stay, all-cause 30-day non-elective readmission rate, and total cost of hospitalization. Multivariate regression analysis was performed to study the impact of IDA on inpatient mortality and non-elective readmissions. Results Of the 72,076 patients discharged from an index hospitalization for CD, 8.1% had IDA. CD patients with IDA had increased length of stays in days (4, interquartile range (IQR): 2 - 6 vs. 3, IQR: 2 - 5; P < 0.001), increased median total charges ($35,160, IQR: $19,786 - $64,126 vs. $31,299, IQR: $17,226 - $59,561; P < 0.001), and were more common to require blood transfusion during hospitalization (13.6% vs. 3.4%, P < 0.001) compared to CD patients without IDA, respectively. IDA was independently associated with increased odds of all-cause 30-day non-elective readmission (odds ratio (OR): 1.254, 95% confidence interval (CI): 1.154 - 1.363, P < 0.001) and increased odds of all-cause 90-day non-elective readmission (OR: 1.396, 95% CI: 1.302 - 1.498, P < 0.001). Conclusions In a large nationwide cohort of patients hospitalized for CD, we observed a significant burden of IDA. Additionally, we found a significant association between IDA and worse hospitalization outcomes.

Background: Few studies evaluated the risk of acute pancreatitis (AP) in patients with Crohn's disease (CD). It's controversial if AP can be considered as an extraintestinal manifestation of CD. We studied this potential association in a retrospective cohort of patients with CD.Methods: We draw our cohort from the Nationwide Readmission Databases 2016 -2018. We used the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify all adult patients admitted with a diagnosis of CD. Patient with a comorbid AP were identified. We analyzed the significant impact of AP on hospitalization outcomes. A multivariate regression analysis was used to identify factors associated with AP. Results:We included 214,622 patients discharged from an index hospitalization for CD, 1.1% had AP. AP was independently associated with higher odds of inpatient mortality (odds ratio (OR): 1.831; 95% confidence interval (CI): 1.345 -2.492, P < 0.001), gallstone disease (OR: 4.047; 95% CI: 3.343 -4.9, P < 0.001), nonalcoholic fatty liver disease (NAFLD) (OR: 3.568; 95% CI: 3.08 -4.133, P < 0.001), and hypercalcemia (OR: 1.964; 95% CI: 1.302 -2.965, P = 0.001). Thirtyday readmission analysis showed that CD patients with AP were more commonly to be readmitted for AP than for any other reason. Conclusions:In our nationwide cohort of CD patients, there was a significant association between AP and worse hospitalization outcomes. Additionally, we found independent associations for having AP that may help identify patients at high risk.

Introduction: Prior literature has shown that in-hospital and postoperative renal failure are independent mortality predictors in acute aortic dissection (AAD). However, there is limited data on chronic kidney disease (CKD) and end-stage renal disease (ESRD) as pre-existing outcome predictors with AAD Methods: The Nationwide Readmission Database was analyzed from 2016 to 2019 for adult patients admitted with a primary diagnosis of AAD. Patients were assessed for CKD and ESRD. Outcomes were measured for the effect of renal dysfunction on 30-day readmission, inpatient mortality, and length of stay (LOS). Results: Aortic dissection occurred in 45,481 patients over the study period, of which 4727 were readmitted. The mean age was 64 years, and logistical regression analysis revealed that patients with ESRD admitted with AAD were 58% more likely to be readmitted (95% CI [1.29 - 1.93], p<0.001) within 30 days than those without (Figure 1). Notably, ESRD patients had a 30% reduction (95% CI 0.57 - 0.86) in in-patient mortality (Figure 2). Mean LOS was also higher for ESRD patients (6.7 days, 95% CI 5.09 - 8.38) while lower for CKD stage 3-5 (-1.06 days, 95% CI -1.62 --0.50) compared with those without renal disease. Discussion: We observed that patients with ESRD and AAD have higher readmission rates and LOS. However, decreased mortality rates compared with patients with CKD stages 3-5 were observed that could be attributed to increased exposure to healthcare interventions secondary to frequent hemodialysis follow-ups, compared with CKD stages 3-5. Early stages of CKD were excluded, given the possibility of a lack of coding in electronic medical records.