Ten-Year Trends of Inflammatory Bowel disease and Total Parental Nutrition Use: Nationwide study from 2010-2020

Abstract

Abstract Background This study examined total parenteral nutrition (TPN) usage trends over the last 10 years, including their nationwide patterns, and the outcomes of the utilization of TPN in patients admitted with inflammatory bowel disease. Methods Using the Nationwide Inpatient Sample (NIS) database from 2010 until 2015, we conducted a retrospective cohort study to identify Inflammatory bowel disease (IBD) hospitalization and discharges, determine rates of parenteral nutrition utilization, and investigate outcomes, including in-hospital mortality and hospital resource utilization. Results The hospitalizations for IBD combining both Crohn’s disease (CD) and ulcerative colitis (UC) initially noted a rising trend in IBD until 2016 followed by a decreasing trend with statistical significance (P < 0.001). A decreasing trend in Total Parenteral Nutrition (TPN) utilization in CD dropped from 6.2–5.4% (P = 0.07). The prevalence of malnutrition in CD cases significantly increased from 11.6–16.6% (P < 0.001), and the use of TPN in malnutrition cases decreased from 25.0–20.0% with statistical significance (P = 0.002). TPN in UC cases also exhibited a downward trend, declining from 5.3–3.1% with statistical significance (P < 0.001). However, there was a noteworthy increase in malnutrition rates, rising from 13.5–17.3% (P = 0.087). Similarly, the utilization of TPN in malnutrition cases among UC cases displayed a significant decrease from 19.9–11.3% (P < 0.001). The combined use of TPN in IBD showed a decreased trend from 5.9–4.3% with statistical significance (P < 0.001).. Comorbidities like Alcohol use, Diabetes, Hypertension, and Obesity have also seen an increasing trend. Conclusions The management of IBD evolved significantly between 2010 and 2020. There is a decline in the trend in TPN usage in both CD and UC suggests a shift in the management of IBD and judicious use of TPN. Clinicians started to adopt more targeted treatment approaches, such as biologics and immunomodulators. These findings underscore the need for ongoing research and collaboration among healthcare professionals to optimize treatment strategies and improve patient outcomes in the ever-changing settings of IBD care.