Infection‐related hospitalizations in the first year after inflammatory bowel disease diagnosis

Abstract

AIM: With the rapid increase in the incidence of inflammatory bowel disease (IBD) in Asia, the natural course of these patients during the early phase of disease remains poorly defined. We determined the incidence and characteristics of infection related hospitalization in the first year of patients newly diagnosed with IBD in Hong Kong. METHODS: Patients newly diagnosed with IBD and enrolled in the territory-wide Hong Kong IBD Registry were identified. Details of their hospitalization within the first 12 months after diagnosis were retrieved and analyzed. RESULTS: 433 newly diagnosed IBD patients were enrolled including 188 Crohn's disease (CD) and 230 ulcerative colitis (UC). Among them, 110 (25.4%) had at least one unscheduled hospitalization in the first year and 34 (7.9%) had infection-related hospitalization leading to 43 (23.3% of total) hospitalizations. Gastrointestinal tract (30.2%), respiratory tract (34.9%) and skin or soft tissues (11.6%) were the commonest sites of infection. Bacterial and viral infections accounted for 46.5% and 20.9% of infective hospitalizations, respectively. Common identified pathogens included Clostridium difficile (16.3%) and Cytomegalovirus (11.6%). Multivariate analysis found that patient's age (OR 1.03; 95% CI 1.01 to 1.06) and the presence of comorbidity (OR 2.32; 95% CI 1.05 to 5.13) were significantly associated with hospitalization from infection in IBD patients. CONCLUSIONS: Infection-related hospitalizations were found in 7.9% of newly diagnosed IBD patients in the first year of diagnosis in Hong Kong, which accounted for about one-quarter of all unscheduled admissions. Older patients with concurrent medical illnesses were at higher risk.