Vaccine-preventable diseases cause most hospitalizations in IBD patients

Many infectious disease-related hospital admissions in patients with inflammatory bowel disease may have been prevented by immunization, suggests a study.

“Patients with IBD are at increased risk for hospitalization due to HZ and varicella,” the researchers said. “Those hospitalized for vaccine-preventable diseases (VPDs) have higher morbidity compared with patients with IBD and nonvaccine-preventable infections (non-VPIs).”

A retrospective study was conducted using the 2013-2017 Nationwide Inpatient Sample databases to explore the prevalence of VPD in patients with IBD, as well as inpatient outcomes. The researchers included all patients aged ≥18 years with International Classification of Diseases, Ninth and 10th Revisions, Clinical Modification (ICD-9/10 CM) codes for IBD, as well as those with VPDs as a principal diagnostic code.

The occurrence and odds of VPD in IBD patients compared with those with no IBD was the primary outcome. Secondary outcomes included inpatient mortality, morbidity, and economic burden compared with patients with IBD and non-VPIs.

A total of 1,622,245 patients had a diagnosis of IBD, of which 3,650 (0.2 percent) had associated VPDs and 131,150 (8.1 percent) had non-VPIs. The most common VPDs identified were influenza, herpes zoster, pneumococcal pneumonia, and varicella. Of these, only herpes zoster and varicella had a higher likelihood of occurrence in IBD patients of all ages.

Of note, older IBD patients were more likely to have VPD than those aged <65 years. In addition, patients with IBD and associated VPD had increased odds of intensive care unit stay, systemic inflammatory response syndrome, and multiorgan failure compared with those with IBD and non-VPI.

“These findings echo the importance of instituting optimal immunization schedules in patients with IBD, particularly in patients 65 years or older,” the researchers said.