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

Buie MJ 1 , Quan J 2 , Windsor JW 1 , Coward S 1 , Hansen TM 3 , King JA 4 Show all authors , Kotze PG 5 , Gearry RB 6 , Ng SC 7 , Mak JWY 7 , Abreu MT 8 , Rubin DT 9 , Bernstein CN 10 , Banerjee R 11 , Yamamoto-Furusho JK 12 , Panaccione R 13 , Seow CH 1 , Ma C 13 , Underwood FE 1 , Ahuja V 14 , Panaccione N 13 , Shaheen AA 1 , Holroyd-Leduc J 1 , Kaplan GG 15 , Global IBD Visualization of Epidemiology Studies in the 21st Century (GIVES-21) Research Group , Balderramo D 16 , Chong VH 17 , Juliao-Baños F 18 , Dutta U 19 , Simadibrata M 20 , Kaibullayeva J 21 , Sun Y 22 , Hilmi I 23 , Raja Ali RA 24 , Paudel MS 25 , Altuwaijri M 26 , Hartono JL 27 , Wei SC 28 , Limsrivilai J 29 , El Ouali S 30 , Vergara BI 31 , Dao VH 32 , Kelly P 33 , Hodges P 33 , Miao Y 22 , Li M 22

Affiliations 

  • 1 Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  • 2 Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  • 3 Section of Gastroenterology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
  • 4 Centre for Health Informatics, University of Calgary, Calgary, Alberta, Canada; Alberta Strategy for Patient Oriented Research Support Unit, Data Platform and Provincial Research Data Services, Alberta Health Services, Calgary, Alberta, Canada
  • 5 Inflammatory Bowel Disease Outpatient Clinics, Catholic University of Paraná, Curitiba, Brazil
  • 6 Department of Medicine, University of Otago, Christchurch, New Zealand
  • 7 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, China
  • 8 Department of Medicine and Microbiology and Immunology, University of Miami, Miami, Florida
  • 9 Inflammatory Bowel Disease Center, University of Chicago, Chicago, Illinois
  • 10 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
  • 11 Inflammatory Bowel Disease Center, Asian Institute of Gastroenterology, Hyderabad, India
  • 12 Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition, National Autonomous University of Mexico, Mexico City, Mexico
  • 13 Department of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 14 Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
  • 15 Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: ggkaplan@ucalgary.ca
  • 16 Gastroenterology Department, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
  • 17 Division of Gastroenterology and Hepatology, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam
  • 18 Department of Gastroenterology, Pablo Tobon Uribe Hospital, Medellín, Colombia
  • 19 Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • 20 Division of Gastroenterology, Department Internal Medicine, Faculty Medicine, Dr. Cipto Mangunkusumo Hospital Indonesia, Universitas Indonesia, Jakarta, Indonesia
  • 21 Research Institute of Cardiology and Internal Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
  • 22 Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan, China; Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
  • 23 Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 24 Gastroenterology Unit, Gut Research Group, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 25 Department of Gastroenterology, National Academy of Medical Sciences, Kathmandu, Nepal
  • 26 Division of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 27 Yong Loo Lin School of Medicine, National University of Singapore, Division of Gastroenterology and Hepatology, National University Hospital, Singapore
  • 28 Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
  • 29 Division of Gastroenterology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 30 Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
  • 31 Centro de Asistencia del Sindicato Médico del Uruguay Cooperativa de Servicios Médicos, Montevideo, Uruguay
  • 32 Internal Medicine, Hanoi Medical University, Hanoi, Vietnam
  • 33 Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, England, United Kingdom; Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia
Clin Gastroenterol Hepatol, 2023 Aug;21(9):2211-2221.
PMID: 35863682 DOI: 10.1016/j.cgh.2022.06.030

Abstract

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, Crohn's 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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