Systematic Review and Meta-Analysis: Risk of Hospitalization in Patients with Ulcerative Colitis and Crohn's Disease in Population-Based Cohort Studies.
Systematic Review and Meta-Analysis: Risk of Hospitalization in Patients with Ulcerative Colitis and Crohn's Disease in Population-Based Cohort Studies.
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系统评价和荟萃分析：基于人群的队列研究中溃疡性结肠炎和克罗恩病的患者住院的风险。
DOI：
10.1007/s10620-021-07200-1
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发表时间：
2022-06
影响因子：
3.1
通讯作者：
Singh S
中科院分区：
文献类型：
--
作者：
Tsai L;Nguyen NH;Ma C;Prokop LJ;Sandborn WJ;Singh S
炎症性肠病（IBD）导致高发病率和计划外的医疗保健利用。我们通过荟萃分析进行了一项系统评价，以估计溃疡性结肠炎（UC）和克罗恩病（CD）患者IBD相关（和全因）住院的累积发生率。通过截至2019年9月3日的系统性综述，我们确定了IBD患者中基于人群的初始队列研究，这些研究报告了诊断后1年、3年和5年的患者水平住院累积发生率。使用随机效应荟萃分析汇总住院风险，并通过混合效应荟萃回归和定性综合分析风险因素。在UC患者（6个队列）中，UC相关住院的1年、3年和5年风险分别为10.4%（95% CI，8.2-13.2）、17.0%（95% CI，14.0-20.4）和21.5%（95% CI，18.0-25.4），具有相当大的异质性。在CD患者（6个队列）中，CD相关住院的1年、3年和5年风险分别为29.3%（95% CI，20.0-40.8）、38.5%（95% CI，26.8-51.7）和44.3%（95% CI，32.7-56.5），具有相当大的异质性。在荟萃回归分析中，在更现代的时代诊断的患者中观察到住院风险稳步下降。发病年龄较小（UC和CD）、广泛性结肠炎（UC）、回肠显性CD、肛周CD和穿透和/或狭窄行为（CD）以及早期需要皮质类固醇和免疫抑制治疗（UC和CD）与住院风险增加相关。大约五分之一和二分之一的UC和CD患者分别在诊断后5年内住院。人口健康管理战略需要减轻计划外的医疗保健利用。
Inflammatory bowel diseases (IBD) lead to high morbidity and unplanned healthcare utilization. We conducted a systematic review with meta-analysis to estimate the cumulative incidence of IBD-related (and all-cause) hospitalization in patients with ulcerative colitis (UC) and Crohn’s disease (CD). Through a systematic review to September 3, 2019, we identified population-based inception cohort studies in patients with IBD that reported patient-level cumulative incidence of hospitalization at 1-, 3- and 5-years after diagnosis. Hospitalization risk was pooled using random-effects meta-analysis, and risk factors analyzed through mixed-effects meta-regression and qualitative synthesis. In patients with UC (6 cohorts), 1-, 3- and 5-year risk of UC-related hospitalization was 10.4% (95% CI, 8.2–13.2), 17.0% (95% CI, 14.0–20.4) and 21.5% (95% CI, 18.0–25.4), respectively, with considerable heterogeneity. In patients with CD (6 cohorts), 1-, 3- and 5-year risk of CD-related hospitalization was 29.3% (95% CI, 20.0–40.8), 38.5% (95% CI, 26.8–51.7) and 44.3% (95% CI, 32.7–56.5), respectively, with considerable heterogeneity. On meta-regression, steady decline in risk of hospitalization was observed in patients diagnosed in a more contemporary era. Younger age at onset (both UC and CD), extensive colitis (UC), ileal-dominant CD, perianal CD and penetrating and/or stricturing behavior (CD) and early need for corticosteroids and immunosuppressive therapy (both UC and CD) were associated with increased risk of hospitalization. Approximately one in five and one in two patients with UC and CD are hospitalized within 5 years of diagnosis, respectively. Population health management strategies are required to mitigate unplanned healthcare utilization.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
24.5
作者：
Bernstein, Charles N.;Loftus, Edward V., Jr.;Moum, Bjorn
通讯作者：
Moum, Bjorn
影响因子：
168.9
作者：
Colombel, Jean-Frederic;Panaccione, Remo;D'Haens, Geert
通讯作者：
D'Haens, Geert
影响因子：
24.5
作者：
Burisch, Johan;Kiudelis, Gediminas;Valantiene, Irena
通讯作者：
Valantiene, Irena
影响因子：
12.6
作者：
Burr, Nicholas E.;Lord, Richard;Subramanian, Venkataraman
通讯作者：
Subramanian, Venkataraman