S1043 Interstitial Lung Disease in Inflammatory Bowel Disease Patients: Insight From National Inpatient Sample Database

Introduction: Interstitial lung disease (ILD) can appear as a rare extraintestinal inflammation in patients with inflammatory bowel disease (IBD) or as an adverse effect of treatment. The association between these two conditions and its impact on IBD patients' morbidity and mortality is not well-documented in existing literature. Understanding this relationship is critical as it may influence treatment plans and patient quality of life. We aimed to conduct a national-level retrospective analysis to evaluate inpatient outcomes of IBD patients with concurrent ILD. Methods: Using ICD-10-CM codes, we identified all hospitalizations primarily diagnosed with IBD from the National Inpatient Database between 2015 to 2019. Exclusion criteria were patients with incomplete data. Patients with and without ILD were compared in terms of basic characteristics and medical comorbidities. Primary outcomes included bowel fistula, colectomy, severe sepsis with septic shock, inpatient mortality, and hospitalization costs. Multivariate logistic regression was used to control for confounding factors and calculate adjusted odds ratios (AOR). Results: Of the 1,339,665 IBD hospitalizations, 5815 (0.434%) had concurrent ILD. Patients with ILD were more likely to have comorbidities such as congestive heart failure (AOR 2.43, 95% CI 2.10-2.81), cardiac arrhythmias (AOR 1.46, 95% CI 1.27-1.67), pulmonary circulation disease (AOR 4.88, 95% CI 4.17-5.71), peripheral vascular disease (AOR 1.25, 95% CI 1.02-1.53), COPD (AOR 2.85, 95% CI 2.51-3.24), rheumatoid arthritis (AOR 3.33 95% CI 2.85-3.89), and obesity (AOR 1.49, 95% CI 1.28-1.74). IBD patients with ILD had higher crude mortality (4.6% vs. 1.5%, OR 3.28, 95% CI 2.49-4.31), longer hospital stays (6.77 vs. 5.34, P< 0.01), and higher hospital charges ($81227 vs. 56477, P< 0.01). After adjusting confounding factors, we noticed a significant higher mortality rate in ILD group compared to non-ILD group (AOR 2.07 95% CI 1.56-2.75). There was no significant difference in colectomy or fistula rates between the ILD and non-ILD groups (Figure 1). Conclusion: Those IBD patients with concurrent ILD tend to have more comorbidities, higher mortality, longer lengths of hospital stay, and higher hospital charges during IBD-related hospitalizations. Further research is warranted to better understand the pathophysiological link between ILD and IBD, which could potentially inform targeted treatment strategies and interventions to improve patient outcomes.Figure 1.: IBD withith ILD vs with ILD.