Crohn’s & Colitis Congress™

Sessions Speakers Exhibitors Floor Plan Buzz

P213 - THE IMPACT OF SMOKING STATUS ON MORTALITY AND OTHER OUTCOMES IN HOSPITALIZED PATIENTS OF INFLAMMATORY BOWEL DISEASE IN UNITED STATES: “THE SMOKER’S PARADOX” (Room Poster Hall)

Introduction: Ulcerative colitis (UC) and Crohn’s disease (CD) result from genetic and environmental factors. Never smoking and formerly smoking increase the risk of UC, whereas smoking exacerbates the course of CD. Methods: We analyzed the National Inpatient Sample (NIS) database for all subjects with primary or secondary discharge diagnosis of UC & CD and aged ≥18 years during the period from 2002-2014. Smokers (both current and former) were then identified using ICD-9-CM code 305.1 or V15.82. All analyses were performed with the use of SAS, version 9.4 (SAS Institute). Results: From 2002-2014, the odds of being a smoker were more in CD than UC among all discharges (25.1% Vs 17.2%, P=<0.001). The odds of being aged below 50 and smoker were more in CD than UC (53.9% Vs 36.9%, P=<0.001). More African Americans in CD were likely to be smoker than UC (10% Vs 7.8%, P=<0.001), and Hispanics and Asians in UC were more likely to smokers than CD (5% Vs 2.9%) & (3.4% Vs 2.5%) respectively. UC patients in northeast and west were more likely to be smokers than CD (20.7% Vs 18.3%) & (21.4% Vs 15 %). CD patients in Midwest and south were more likely to be smokers than UC (29.3% Vs 26%) & (37.2% Vs 31.9%) respectively. More females in CD were smokers than females in UC (57% Vs 47.3%, P=<0.001). The mortality in both UC & CD patients without smoking was higher than with smoking status (2.5% Vs 1.2%, P=<0.001) & (1.2% Vs 0.7%, P=<0.001) respectively. Despite significant increase in trend of smoking in IBD from 2002 (12.6%) to 2014 (32.4%), the increase was not replicated in outcomes of mortality, length of stay and cost of care. Conclusions: Smoking was more prevalent in CD than UC, with the rising trend of smoking in this cohort of IBD. Interestingly smoker status was found to be paradoxically associated with favorable outcomes in terms of mortality, routine discharges, length of stay and cost of care.