No abstract

The relationship between inflammatory bowel disease (IBD) and depression is complicated. The effect of depression on ulcerative colitis (UC) and Crohn's disease (CD) among the inpatient US population has not previously been studied. We retrospectively analyzed patients admitted with UC and CD from 2016 to 2019 using the National Inpatient Sample database. Our primary outcome was the effect of depression on hospital length of stay (LOS), costs, and mortality. Secondary outcomes included the comparison between UC and CD cases. In the UC population, 13.4% had depression, compared to 14.9% in the CD population. LOS was longer in UC and CD patients with depression (P < 0.001). Subgroup analysis revealed that LOS was longer in CD patients than UC patients in the depressed cohort (P < 0.001). Inpatient hospital costs were lower in IBD patients with depression (P < 0.001). Subgroup analysis revealed that hospital cost was $17,974 higher in CD patients than UC patients (P < 0.001). Depression did not increase mortality in the IBD population but increased LOS, with a greater impact on CD than UC. White women were found to have an increased prevalence of depression in the IBD population.

Background: Recent incidence trends of pancreatic cancers were reviewed by demographics and histologic type to observe any new findings. Methods: Data was used from the Surveillance, Epidemiology, and End Results (SEER) registry 18 (2000-2017) and it underwent temporal trend analysis. Pancreatic cancer incidence rates were reported based on histological subtype and demographics. Results: The incidence rate of white males increased significantly during 2000-2017 (annual percent change (APC) = 3.5%) compared to previously reported APCs. The incidence of white females grew from an APC of 1.29% to 2.9%. Rates among black ethnicity increased with an APC of 4.2%. Rates among Hispanics and other ethnicities also showed increment. The rates for ductal adenocarcinoma showed a positive trend in all races, with the APC ≥ 6 % for females and APC ≥ 6.5 % for males. The rates of non-secretory endocrine tumors showed a decline in both genders of all five races in recent years after showing an initial positive trend till 2010. Rates for pancreatic adenocarcinoma continued to rise in all ethnicities from 2000-2017. Interestingly, there was a rise in carcinoid type pancreatic neuroendocrine tumors (PNETs) in all ethnicities. Cumulatively, males had a higher incidence than females; male to female Incidence Risk Ratio (IRRs) was 1.32. The IRR was > 1 for age groups ≥ 35 years. The male to female IRRs was less than 1 for cystic adenocarcinoma, secretory endocrine, and solid pseudopapillary carcinomas (IRR = 0.5, 0.9, and 0.2 respectively, confidence intervals 0.4–0.6 and 0.9-1.3, 0.2–0.3, respectively). Conclusion: Pancreatic cancer incidence continued to rise in the years 2000-2017. However, incidence differed by demographics and histologic type. Interestingly, recent years discerned a rise in PNETs (carcinoid type) which has not been reported previously.

Constipation can be a significant clinical challenge that can compromise management plans and prolong hospital stays. Our goal was to examine the effects of constipation on mechanically ventilated patients, with outcomes related to inpatient stays. We retrospectively analyzed critically ill patients hospitalized with constipation in the 2016 to 2019 National Inpatient Sample (NIS) database. Constipation was defined using Rome IV criteria. Critically ill patients were defined as mechanically ventilated from admission day 1. Our primary outcome was length of stay (LOS) and total hospital charge. Secondary outcomes included predictors of mortality in critically ill patients with constipation. The study included 2,351,119 weighted discharges of mechanically ventilated patients in the NIS database. Of these, 3.7% had constipation. The adjusted LOS was 3.4 days longer in patients with constipation vs those without it (P < 0.001). The adjusted inpatient hospital cost was $31,762 higher in patients with constipation (P < 0.001). Men had higher LOS and inpatient costs. Constipation was not associated with increased inpatient mortality (P < 0.001). Several conditions increased mortality in critically ill patients with constipation, including peritonitis, fecal impaction, and bowel obstruction.