Assessment of comorbidity reveals socioeconomic factors and frailty in hospitalized and outpatient IBD patients.
Background Inflammatory bowel disease (IBD) may be burdened by other comorbid conditions. We herein sought to assess comorbidity in hospitalized and non-hospitalized IBD patients. Methods This was part of the San MAtteo Complexity (SMAC) study (2017–2019). Data of hospitalized IBD patients were compared to gender- and age-matched IBD outpatients in a 2:1 fashion. The association of comorbidity in relation to hospitalization and clinical and socioeconomic factors was assessed. Results We included 104 patients, 27 hospitalized (median age 49 years, IQR 32-70) and 77 outpatients (median age 54 years, IQR 37-68). Comorbidity was reported in 63/104 patients (60.6%), of whom 45 (58.5%) non-hospitalized and 18 (66.6%) hospitalized. Patients with comorbidity were older (median 60 years, IQR 44-61 vs median 40 years, IQR 28-50 vs; p<0.001), had a higher Cumulative Illness Rating Scale severity index (median 1.85, IQR 1.5-2.5 vs median 1.31, IQR 1.2-2.5; p=0.002), were more commonly female (37, 60.7% vs 14, 35.0%; p=0.01), frailer (14, 22.2% vs 1, 2.4%; p=0.004), and had a lower educational level (13, 20.6% vs 2, 4.9%; p=0.04). In a bivariable analysis, factors associated to comorbidity were age >65 years (OR 5.30, 95% CI 1.81-15.55; p=0.002), female sex (OR 2.92, 95% CI 1-27-6.71; p=0.012), income <1000€ (OR 3.04, 95% CI 1.09-8.44; p=0.033), schooling <8 years (OR 5.09, 95% CI 1.08-23.96; p=0.039), frailty (OR 12.56, 95% CI 1.48-106.45; p=0.020), and polypharmacy (OR 10.41, 95% CI 1.85-59.38; p=0.008). Conclusion A high prevalence of comorbidity was found in IBD, possibly related to low socioeconomic status and poor educational level.
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Lenti et al. (2025) studied this question.
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