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hospitalization rates

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kyle_dn
Regular Member
Joined : Nov 2021
Posts : 40
Posted 8/1/2022 11:59 AM (GMT -8)
Just wondering how many of us here have been hospitalized for our UC or CD? And if you were hospitalized did you respond to IV steroids or did you need rescue therapy from inflix or cycosprine or did you fail everything and need surgery?

I read that the mort rate for IBD hospitalization in the 1940s was 1 in 3.
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 7543
Posted 8/1/2022 2:34 PM (GMT -8)
I should have been when I first got UC because of how ill I was, but I was a 23 year old and my dad didn't think I was on his insurance anymore (ended up I was...) and my insurance at my new job had not kicked in yet, so I didn't go to the ER. I've only been hospitalized twice--first time I thought was a flare, but turned out to be a really bad reoccuring campylobacter infection. The second time was shortly after for c diff. I did receive IV steroids until we realized I actually had infections. I do NOT do well on IV steroids...they make me go nuts emotionally.

Yikes, I'm glad things have improved since the 1940s for us.
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ks1905
Veteran Member
Joined : Sep 2005
Posts : 6335
Posted 8/1/2022 3:05 PM (GMT -8)
I was hospitalized when I first got sick, I think it was about 24 days. I didn't respond to steroids so they gave me Cyclosporine.

My GI says that many hospitalizations happen when we first get diagnosed and then after we have maintenance meds in our bodies we tend to not flare as bad. It's just a generalization.

I went off of my meds one time and ended up back in the hospital on Cyclosporine for 21 days. I did not like taking 6MP so I stopped. That was a mistake.

My last flare I ended up in the hospital and not responding to biologicals so I had surgery. It was 4 separate hospitalizations because I had a 3-part surgery and one admission for a blockage.

I'm somewhere above 100 days in the hospital for my IBD. This isn't very common anymore among IBD patients. We have great medications now.
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 2469
Posted 8/1/2022 3:45 PM (GMT -8)
I was hospitalized when I was first diagnosed in 2013 for about a week, IV steroids and sent home with pred taper and oral mesalamine.

2nd big flare in 2016 for 3 days I think (it was a long holiday weekend), IV steroids again and sent home with pred taper and plan to go on Entyvio,

3rd big flare in 2018 -- hospitalized overnight to get blood transfusions
This last flare continued until I started Remicade in 2019. Lots of steroids and iron transfusions but no further hospitalizations during that period of time.
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16404
Posted 8/1/2022 3:57 PM (GMT -8)
I've never been hospitalized for my UC.

It's a good question, what does the medical literature say?

(Published 2004). "There were an estimated 359,124 and 214,498 admissions for CD and UC, respectively. The overall hospitalization rate for CD was 18.0 per 100,000 and that for UC was 10.8 per 100,000."

Source;. https://academic.oup.com/ibdjournal/article/13/12/1529/4652999

(Published 2007) "From 1990 to 2003, the hospitalization rates for patients with a primary diagnosis of IBD per 100,000 people ranged from 9.3 to 17.1 for CD and 8.2 to 12.4 for UC"

Source:.
https://www.sciencedirect.com/science/article/abs/pii/s1542356507001061

So, the odds of you or I needing hospitalization for our UC is pretty minimal. There's an obvious bias to severe pancolitis cases over those who are mild Proctitis though. Severity and extent of UC has a big impact on who's most likely to need a hospitalization. And our gasteroenterologists know this and keep a closer watch on their patients who are likely to need it, with labs etc.

Regard mortality rates, yours/mine isn't statistically significantly increased from our peers. IBD won't kill you with modern medicine, surgery, and treatment recommendations from our doctor's. You won't see IBD on a death certificate. It's possible to die of complications related to having an IBD, like a sepsis from immunosuppression (blood traveling infection) as an example. Incredibly rare but it's happened to a few
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1757
Posted 8/1/2022 5:11 PM (GMT -8)
I seem to remember the mortality rate in the 19th century was more like 60% but I forget where I read that....

Hospitalization rates have reduced significantly in the last 20 years with the advent of biologics and other drugs.

The chance of dying from UC these days is very small but not zero. Emergency colectomy still has a mortality rate of a few percent.
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clo2014
Veteran Member
Joined : Feb 2015
Posts : 1773
Posted 8/1/2022 8:53 PM (GMT -8)
Let's see.... I'm that person that causes all our numbers to go up. I was hospitalized for sepsis for 3 weeks, then for a fistula for 2 weeks, then back for sepsis for 2 weeks..... And that was when I was first diagnosed.

Since then I have had 3 surgeries with a stay rate of about 8 to 10 days each surgery, (I coded twice during those), 5 obstructions with stays of 7 days each, (1 had a dilation in there) and two more times for sepsis again with IV antibiotics.

I think that's it. There are the other times I went to the ER and told them to send me home with steroids... Lol.... I just refused to stay. Thats about 5 more times. Then there was that pyoderma gangrenosum bout where they wanted me to go in but I stayed at home....

Gosh, I just realized how bad it's been... I've been listing only the things I considered major. Yikes!!! But I am grateful. 20 years ago I might not have made it. They started me on Remicade in the first year. I had such fast healing the scar tissue caused my obstructions...and my fistulas caused the sepsis issues.

And now.... Now I have been struggling with recurring antibiotic resistant UTIs, refusing to go to the hospital until I absolutely have to. No fever.. not going.

Appreciate every moment you can.

Clo
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 7543
Posted 8/1/2022 9:09 PM (GMT -8)
I'm really surprised at those super low hospitalization rates iPoop shared. I thought they'd be much higher. I don't plan to read the studies shared but I'm guessing those stats are per year? Still low but that's not a lifetime chance of ever being hospitalized, I doubt.
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Pinocchio
Regular Member
Joined : Jun 2022
Posts : 23
Posted 8/2/2022 2:20 AM (GMT -8)
Been 4 weeks in the hospital with my first flare (severe Pancolitis), 4 weeks later I got back in the ER because of C diff for 2 weeks. Been an horrible introduction to UC for me lol.
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damo123
Veteran Member
Joined : Jul 2007
Posts : 942
Posted 8/2/2022 2:24 AM (GMT -8)
Fulminant colitis cases need immediate hospitalization, i.e. high temp, ESR > 40, 10 or more bloody BMs a day, heart-beat over 90 per minutes. I would say these make up the vast majority of hospitalised cases and as iPoop infers fulminant colitis is for the most part an effect of pancolitis. The consequences of not addressing such cases are bowel perforation, sepsis and death. So GI do not mess around here.

A google search seems to imply that even those who do respond in hospital to fulminant colitis, there is a 50% chance of collectomy of some sort within 3-6 months.
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momto2boys
Veteran Member
Joined : Jun 2013
Posts : 2580
Posted 8/2/2022 6:16 AM (GMT -8)
I have never been hospitalized for my UC. I was close to going in 2018 but 40 mg of pred started to work after 6 weeks at a lower dose (including a taper). I added Imuran in 2019 when I couldn’t come off of pred successfully.
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16404
Posted 8/2/2022 6:50 AM (GMT -8)
It's also important to recognize that most IBD cases are mild. There's a definite bias here toward severe pancolitis cases in our posters here. Pancolitis makes up 10 percent of all UC cases, yet the majority of posters in this thread are severe pancolitis. There's a lot of mild cases out there, living their lives, not thinking about UC enough to post regularly about it.

Studies were analyzing actual hospitalization data where a person had UC, CD, or a common complication thereof. They're multiple years. Two studies were linked, one from 1990 to 2003, the other from 1998 to 2004.

Both studies are prior to biological meds being used earlier and more broadly among CD and UC patients.

The exact data and methodology is included with great detail. They're gated behind a paywall so not available for everyone to delve into unless you're near a university with subscriptions to the major journals.
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1757
Posted 8/2/2022 7:16 AM (GMT -8)
This paper from 2021 says it is estimated that 18-25% of UC patients will require hospitalization at least once.

https://academic.oup.com/crohnscolitis360/article/3/3/otab029/6295642

Indeed, the most refractory cases tend to turn up on healingwell which paints a biased picture smile
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Sara14
Veteran Member
Joined : Mar 2007
Posts : 7543
Posted 8/2/2022 8:22 AM (GMT -8)
Thanks for sharing.
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damo123
Veteran Member
Joined : Jul 2007
Posts : 942
Posted 8/2/2022 10:28 AM (GMT -8)
When I was first diagnosed and joined HW in 2007 I rem googling to see what surgery rates were for UC and they were then quoted at 25-40%. It is amazing that some google searches today still report these exact rates which clearly are a statistic of the pre biologic era. I'm not sure what the new agreed estimate of this is but it is definitely not in that range anymore and is a good example of how Dr Google can be misleading.

Hospitialzation and surgery rates will always remain highest in the pancolitis sub population and stresses more why it is important to stay on top of your diseases and not leave it spread. There is also a difference between disease activity and prognosis. You can have inactive disease but still retain a poor prognosis if you meet those conditions....i.e. under 40 at diagnosis, required more than 2 courses of steroids, deep ulcers on first colonscopy, pancolitis on diagnosis. Ignoring of course those who enter hospital and surgery due to malignacy issues. With that said I rem a poster here from years ago (Suebear???) who had surgery because 10 years of inflammation the size of a dime in here rectum wreaked havoc on her. She always maintained that surgery gave her her life back.
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VanJordan
Veteran Member
Joined : Dec 2019
Posts : 566
Posted 8/2/2022 12:47 PM (GMT -8)
I've been hospitalized 5 times. Each time I was given methylprednisone by IV which rescued me from dying but didn't really help my flare. Each time, I transitioned off IV prednisone to oral and went home to try and figure out how to help myself. Biologics and maintenance meds didn't work on me... except Entyvio which partially helped me for about 14 months before becoming ineffective. The ASA drugs orally and rectally made caused stomach bleeding and turned my UC fulminant.

They wanted to do surgery of course, but I refused each time. Colectomy is not for me.

Dr. Pravda's reductive theory of disease and treating my disease as a redox problem put me into remission within a month after 2.5 years of prednisone-dependent flaring. I am grateful.
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clo2014
Veteran Member
Joined : Feb 2015
Posts : 1773
Posted 8/2/2022 4:04 PM (GMT -8)
I try to remember to put in a disclaimer. I am that odd little bird that raises our numbers. My GI and Colorectal doctor's at Dallas Baylor (they are both directors over their departments) have informed me I'm one of the most severe cases they have ever seen. So we are all on a learning curve--but so far, knock on wood- they have been willing to think out of the box and keep me alive. But .. my numbers do not reflect the norm at all.

Today....They have both informed me that the rate of hospitalizations for UC and Crohn's has dropped tremendously with the new treatments and because people are deligent regarding their health care and medications. I forgot the percentages.

And in my support groups.... UC/Crohn's... fewer people speak about being admitted. They complain about having to go to the bathroom 4 times a day.... They are out there still Rock climbing, biking, skiing... Living their lives... They have mild disease...But those 4 times a day are enough to cause concern and "looking for the closest bathroom" syndrome.

Clo

Post Edited (clo2014) : 8/2/2022 5:10:39 PM (GMT-7)

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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1757
Posted 8/2/2022 4:13 PM (GMT -8)
I go up to four times a day in remission.... As long as it's not urgent I'm happy
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clo2014
Veteran Member
Joined : Feb 2015
Posts : 1773
Posted 8/2/2022 4:36 PM (GMT -8)
I know. I sorta chuckle when we are talking. 4 times. I told them that 4 times is a fantasy for people with more severe disease. It's called remission for some. They understand that, but they are really curious about other people, their symptoms and how to control their disease. I think support groups and being able to somewhat discuss these diseases helps others do the right thing and keep their disease in check. By taking those steps they might be able to avoid hospitalizations.

There are more people in my support group that have mild disease than severe disease now. I'm glad to see that.

Clo
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1757
Posted 8/2/2022 5:59 PM (GMT -8)
Well... my GI said some people even go 5x a day and that's still ok if it's normal for them. I've been scoped and had zero inflammation with going 4x a day so I know not to worry about it. I do have scar tissue and a narrow lumen in the sigmoid colon from years of flaring though so i assume that contributes (plus i eat a lot of fibre).
I was heading for surgery before I went on xeljanz. It had just been licensed a couple of months before I started it. I do often think about the different path my life would have taken if I'd been at the same point a year earlier.
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 423
Posted 8/3/2022 5:39 AM (GMT -8)
Hospitalised from complications of UC swelling joints/pancreatitis and PE but that was the first time since my diagnosis in 2006. It was also my worst flare.. probably my only real flare
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Ms2011
Regular Member
Joined : May 2020
Posts : 86
Posted 8/3/2022 7:50 AM (GMT -8)
Have UC for 5 years, never been hospitalised but very close to it when I was first diagnosed with pancolitis but I had a 2 and 5 year old that I had to look after.
Flagyl and Budesonide put me into symptomatic remission within 2 weeks and Pentasa kept me in remission for the next 2 years.
On Humira for the past 2 years, just recently gone from fortnightly injections to weekly injections. I usually go once a day, occasionally twice though consistency could be better, 7 is the most I was going while flaring but bad urgency.
My husband can go 3 or 4 times a day and he has no bowel issues just as a contrast.
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DaisyZee
Regular Member
Joined : Feb 2020
Posts : 31
Posted 8/3/2022 8:31 AM (GMT -8)
Hospitalized in October of 2020 after 10 years with UC. Thought I was headed for colectomy, but I was put on Remicade and have been in remission since about March of 2021. I still have blips and occasional loose stools. But mostly I go once to three times a day. Fingers crossed that Remicade works for me for a long time.
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Charlie789
Regular Member
Joined : Jul 2013
Posts : 132
Posted 8/4/2022 7:44 AM (GMT -8)
There is a more severe form of colitis than pancolitis...fulminant colitis and accounts for most hospitilizations and deaths. It is still associated with high mortality....between 3-5% even in biologic era:

https://acreditacion-fmc.org/SciAm/segundaconvocatoria/pdf/SCI_37.pdf
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FlowersGal
Veteran Member
Joined : Feb 2017
Posts : 1597
Posted 8/4/2022 1:15 PM (GMT -8)
I was hospitalized when first diagnosed. Mainly because it was going to take weeks to months to get a GI appt for my bloody diarrhea! Welcome to US specialty healthcare! Treated for pancreatitis for 9 days by the first hospital because my enzyme numbers were 3x normal but I knew I was misdiagnosed because I had no pain The problem was my massive diarrhea with bleeding but they did nothing for that. So I checked myself out and into a different hospital where they finally addressed that and I had progressed to severe pancolitis by that point and spent another 9 days in semi-ICU with heart monitors 24/7 as my heart rate wasn’t dropping below 100. Fun times.
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