S703 Chronic Depression Is Associated With Negative Outcomes in Patients Admitted for Inflammatory Bowel Disease

Introduction: Inflammatory bowel disease (IBD) is a known risk factor for the development of mental illness, including depression. However, a bidirectional relationship between IBD and depression has also been recognized, in which depression not only affects a patient’s quality of life but influences the use of healthcare and efficacy of IBD treatment. Therefore, the aim of this study is to assess the outcomes of patients admitted for IBD who had an associated diagnosis of chronic depression. Methods: Observational, retrospective study using the NIS 2016 and 2017. International Classification of Diseases – Clinical Modification (ICD-CM) diagnostic codes were used to identify all patients with a principal diagnosis of IBD. Patients with chronic depression were identified using respective ICD codes. The primary outcome was the odds of inpatient mortality in patients with IBD and depression compared to patients with IBD and no depression. Secondary outcomes included morbidity measures and inpatient resource utilization. Multivariate regression analysis was used to adjust for gender, age, Charlson Comorbidity Index, income in patient zip code, hospital region, location, size and teaching status. Results: A total of 205,074 patients admitted for IBD were identified, out of which 670 (0.33%) had associated diagnosis of chronic depression. The mean age in patients with and without depression was 41.1 and 42.8 years, while 54.1% and 45.9% were female, respectively. For the primary outcome, although patients with IBD and depression did display increased mortality adjusted odds ratio (aOR) of 3.63, it did not reach statistical significance. Of the morbidity measures, patients with IBD and depression displayed increased odds of shock (aOR 4.65, p< 0.01), as well as increased additional adjusted hospitalization costs, hospitalization charges and length of hospitalization compared to patients with IBD without chronic depression. Conclusion: Chronic depression in patients with IBD was associated with increased odds of shock, hospital costs, hospitalization charges and hospitalization length of stay compared to patients with IBD and no chronic depression. This study highlights the importance of routine assessment and treatment of clinical depression as a health maintenance measure in patients with IBD. However, taking disease severity into account will be of paramount importance in future studies. Therefore, the inclusion of mental health providers to the IBD multidisciplinary care team is of paramount importance.