Intest Res.  2018 Apr;16(2):216-222. 10.5217/ir.2018.16.2.216.

Characteristics and management of patients with inflammatory bowel disease between a secondary and tertiary hospitals: a propensity score analysis

Affiliations
  • 1Department of Surgery, Goo Hospital, Daegu, Korea.
  • 2Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. dandy813@hanmail.net
  • 3Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
  • 4Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
  • 5Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu, Korea.

Abstract

BACKGROUND/AIMS
This study aimed to compare the clinical characteristics and management patterns of inflammatory bowel disease (IBD) patients in a secondary hospital (SH) with those in tertiary referral centers (TRC).
METHODS
Data from IBD patients in SH and 2 TRCs were retrospectively reviewed. The cumulative thiopurine use rate was compared between hospitals after controlling for different baseline characteristics using propensity score matching.
RESULTS
Among the total of 447 patients with IBD, 178 Crohn's disease (CD) and 269 ulcerative colitis (UC) patients were included. Regarding initial CD symptoms, patients from SH were more likely to show perianal symptoms, such as anal pain or discharge (56.6% vs. 34.3%, P=0.003), whereas those from TRCs more often had luminal symptoms, such as abdominal pain (54.9% vs. 17.1%, P < 0.001), diarrhea (44.1% vs. 18.4%, P < 0.001), and body weight loss (9.8% vs. 1.3%, P=0.025). Complicating behaviors, such as stricturing and penetrating, were significantly higher in TRCs, while perianal disease was more common in SH. Ileal location was more frequently observed in TRCs. For UC, SH had a more limited extent of disease (proctitis 58.8% vs. 21.2%, P < 0.001). The cumulative azathioprine use rate in SH was significantly lower than that in TRCs in both CD and UC patients after controlling for disease behavior, location, and perianal disease of CD and extent of UC.
CONCLUSIONS
The clinical characteristics and management of the IBD patients in SH were substantially different from those in TRCs. Thiopurine treatment was less commonly used for SH patients.

Keyword

Inflammatory bowel disease; Secondary care; Tertiary care centers; Propensity score

MeSH Terms

Abdominal Pain
Azathioprine
Body Weight
Colitis, Ulcerative
Crohn Disease
Diarrhea
Humans
Inflammatory Bowel Diseases*
Phenobarbital
Propensity Score*
Retrospective Studies
Secondary Care
Tertiary Care Centers*
Azathioprine
Phenobarbital
Full Text Links
  • IR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error