Estimated hospitalization rates for Crohn’s disease have increased in the U.S., despite the introduction of treatments that researchers expected would improve remission and reduce hospitalizations.
This led researchers to conclude that patient education efforts should attempt to increase awareness of the importance of adherence to medication and factors that can trigger exacerbation of the disease.
The findings were presented in a report from the Centers for Disease Control and Prevention (CDC), which investigated how the rates of hospital admissions and surgical procedures had changed in the decade spanning 2003 to 2013.
The report, “Hospitalizations for Crohn’s Disease — United States, 2003–2013” was published in the CDC’s Morbidity and Mortality Weekly Report, and tracked hospitalization rates for Crohn’s as the main diagnosis and as any diagnosis.
Looking at Crohn’s as the main diagnosis, there was no increase in hospital rates. But when Crohn’s was considered as any diagnosis, they noted an increase of 35.1%, from 44.2 per 100,000 people to 59.7 per 100,000 individuals.
The total number of hospitalizations increased from 120,209 in 2003 to 196,480 in 2013.
Small bowel resections during hospital stays decreased from 4.9% in 2003 to 3.9% in 2013. In comparison, colorectal resection and fistula repair rates remained similar throughout the period.
An earlier report, covering the years 1998 to 2004, found a yearly increase in hospitalizations of 4.3% for Crohn’s disease as the main diagnosis. Although researchers noted that this trend did not continue, they did note the lack of a rate reduction.
Newer treatments were expected to increase rates of remission and reduce hospital admissions rates. But the team figured that the new report may still signify a new downward trend.
“Although this result suggests that the available treatments have not increased clinical remissions or reduced hospitalizations, it is possible that these trends indicate the beginning of a reversal of the increased hospitalizations and surgical procedures observed in the years leading up to the study period,” they wrote.
However, they also acknowledged that since researchers do not know why people develop Crohn’s, it is difficult to know which changes in public health practices could potentially lower disease rates.
Still, known triggers such as smoking and stress should be addressed in patient education efforts, as should the importance of adherence to medication to prevent hospitalizations.
“Professional education should continue to increase awareness of the signs and symptoms of Crohn’s disease and improve diagnosis and management,” they wrote.