Global Hospitalization Trends for Crohns Disease and Ulcerative Colitis in the 21st Century: A Systematic Review With Temporal Analyses

Buie M.J. Quan J. Windsor J.W. Coward S. Hansen T.M. King J.A. Kotze P.G. Gearry R.B. Ng S.C. Mak J.W.Y. Abreu M.T. Rubin D.T. Bernstein C.N. Banerjee R. Yamamoto-Furusho J.K. Panaccione R. Seow C.H. Ma C. Underwood F.E. Ahuja V. Panaccione N. Shaheen A.-A. Holroyd-Leduc J. Kaplan G.G. Balderramo D. Chong V.H. Juliao-Baños F. Dutta U. Simadibrata M. Kaibullayeva J. Sun Y. Hilmi I. Raja Ali R.A. Paudel M.S. Altuwaijri M. Hartono J.L. Wei S.C. Limsrivilai J. El Ouali S. Vergara B.I. Dao V.H. Kelly P. Hodges P. Miao Y. Li M.
August 2023 W.B. Saunders

Clinical Gastroenterology and Hepatology
2023 #21 Issue 9 2211 - 2221 pp.

Background & Aims: The evolving epidemiologic patterns of inflammatory bowel disease (IBD) throughout the world, in conjunction with advances in therapeutic treatments, may influence hospitalization rates of IBD. We performed a systematic review with temporal analysis of hospitalization rates for IBD across the world in the 21st century. Methods: We systematically reviewed Medline and Embase for population-based studies reporting hospitalization rates for IBD, Crohns disease (CD), or ulcerative colitis (UC) in the 21st century. Log-linear models were used to calculate the average annual percentage change (AAPC) with associated 95% confidence intervals (95% CIs). Random-effects meta-analysis pooled country-level AAPCs. Data were stratified by the epidemiologic stage of a region: compounding prevalence (stage 3) in North America, Western Europe, and Oceania vs acceleration of incidence (stage 2) in Asia, Eastern Europe, and Latin America vs emergence (stage 1) in developing countries. Results: Hospitalization rates for a primary diagnosis of IBD were stable in countries in stage 3 (AAPC, −0.13%; 95% CI, −0.72 to 0.97), CD (AAPC, 0.20%; 95% CI, −1.78 to 2.17), and UC (AAPC, 0.02%; 95% CI, −0.91 to 0.94). In contrast, hospitalization rates for a primary diagnosis were increasing in countries in stage 2 for IBD (AAPC, 4.44%; 95% CI, 2.75 to 6.14), CD (AAPC, 8.34%; 95% CI, 4.38 to 12.29), and UC (AAPC, 3.90; 95% CI, 1.29 to 6.52). No population-based studies were available for developing regions in stage 1 (emergence). Conclusions: Hospitalization rates for IBD are stabilizing in countries in stage 3, whereas newly industrialized countries in stage 2 have rapidly increasing hospitalization rates, contributing to an increasing burden on global health care systems.

Crohns Disease , Epidemiology , Hospitalization Rates , Inflammatory Bowel Disease , Ulcerative Colitis

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Department of Medicine, University of Calgary, Calgary, AB, Canada
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
Section of Gastroenterology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
Centre for Health Informatics, University of Calgary, Calgary, AB, Canada
Alberta Strategy for Patient Oriented Research Support Unit, Data Platform and Provincial Research Data Services, Alberta Health Services, Calgary, AB, Canada
Inflammatory Bowel Disease Outpatient Clinics, Catholic University of Paraná, Curitiba, Brazil
Department of Medicine, University of Otago, Christchurch, New Zealand
Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong
Department of Medicine and Microbiology and Immunology, University of Miami, Miami, Florida, United States
Inflammatory Bowel Disease Center, University of Chicago, Chicago, IL, United States
Inflammatory Bowel Disease Clinical and Research Centre, Department of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
Inflammatory Bowel Disease Center, Asian Institute of Gastroenterology, Hyderabad, India
Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition, National Autonomous University of Mexico, Mexico City, Mexico
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
Gastroenterology Department, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
Division of Gastroenterology and Hepatology, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam, Brunei Darussalam
Department of Gastroenterology, Pablo Tobon Uribe Hospital, Medellín, Colombia
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Division of Gastroenterology, Department Internal Medicine, Faculty Medicine, Dr. Cipto Mangunkusumo Hospital Indonesia, Jakarta, Universitas Indonesia, Indonesia
Research Institute of Cardiology and Internal Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Yunnan, Kunming City, China
Clinical Research Center for Digestive Diseases, Yunnan, Kunming, China
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Gastroenterology Unit, Gut Research Group, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Department of Gastroenterology, National Academy of Medical Sciences, Kathmandu, Nepal
Division of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Yong Loo Lin School of Medicine, National University of Singapore, Division of Gastroenterology and Hepatology, National University Hospital, Singapore
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
Division of Gastroenterology, Siriraj Hospital, Bangkok, Mahidol University, Thailand
Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
Centro de Asistencia del Sindicato Médico del Uruguay Cooperativa de Servicios Médicos, Montevideo, Uruguay
Internal Medicine, Hanoi Medical University, Hanoi, Viet Nam
Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London, England, London, United Kingdom
Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia

Department of Medicine
Department of Community Health Sciences
Section of Gastroenterology
Centre for Health Informatics
Alberta Strategy for Patient Oriented Research Support Unit
Inflammatory Bowel Disease Outpatient Clinics
Department of Medicine
Department of Medicine and Therapeutics
Department of Medicine and Microbiology and Immunology
Inflammatory Bowel Disease Center
Inflammatory Bowel Disease Clinical and Research Centre
Inflammatory Bowel Disease Center
Inflammatory Bowel Disease Clinic
Department of Gastroenterology
Gastroenterology Department
Division of Gastroenterology and Hepatology
Department of Gastroenterology
Department of Gastroenterology
Division of Gastroenterology
Research Institute of Cardiology and Internal Diseases
Department of Gastroenterology
Clinical Research Center for Digestive Diseases
Division of Gastroenterology
Gastroenterology Unit
Department of Gastroenterology
Division of Gastroenterology
Yong Loo Lin School of Medicine
Department of Internal Medicine
Division of Gastroenterology
Digestive Disease Institute
Centro de Asistencia del Sindicato Médico del Uruguay Cooperativa de Servicios Médicos
Internal Medicine
Blizard Institute
Tropical Gastroenterology and Nutrition Group

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