Abstract：
INTRODUCTION:Crohn's disease (CD) and ulcerative colitis (UC) are associated with considerable direct healthcare costs. There have been few comprehensive analyses of all IBD- and non-IBD comorbidities that determine direct costs in this population. METHODS:We used data from a validated cohort of patients with inflammatory bowel disease (IBD). Total healthcare costs were estimated as a sum of costs associated with IBD-related hospitalizations and surgery, imaging (CT or MR scans), outpatient visits, endoscopic evaluation, and emergency room (ER) care. All ICD-9 codes were extracted for each patient and clustered into 1804 distinct phecode clusters representing individual phenotypes. A phenome-wide association analysis (PheWAS) was performed using logistic regression to identify predictors of being in the top decile of costs. RESULTS:Our cohort is comprised of 10,721 patients with IBD among whom 50% had CD. The median age was 46 years. The median total cost per patient is $11,203 (IQR $2396-30,563). The strongest association with total healthcare costs was intestinal obstruction without mention of hernia (p = 5.93 × 10-156) and other intestinal obstruction (p = 9.24 × 10-131). In addition, strong associations were observed for symptoms consistent with severity of IBD including the presence of fluid-electrolyte imbalance (p = 1.90 × 10-130), hypovolemia (p = 1.65 × 10-114), abdominal pain (p = 7.29 × 10-60), and anemia (p = 1.90-10-83). Cardiopulmonary diseases and psychological comorbidity also demonstrated significant associations with total costs with the latter being more strongly associated with ER visit-related costs. CONCLUSIONS:Surrogate markers suggesting possible irreversible bowel damage and active disease demonstrate the greatest influence on IBD-related healthcare costs.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Cai W,Cagan A,He Z,Ananthakrishnan ANdoi
10.1007/s10620-020-06329-9subject
Has Abstractpub_date
2020-05-20 00:00:00eissn
0163-2116issn
1573-2568pii
10.1007/s10620-020-06329-9pub_type
杂志文章abstract：:A variety of human disease conditions are associated with chronic intestinal disorders or enteropathies that are characterized by intestinal inflammation, increased gut permeability, and reduced capacity to absorb nutrients. Such disruptions in the homeostasis of the gastrointestinal (GI) tract can lead to symptoms of...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章,评审
doi：10.1007/s10620-014-3322-0
更新日期：2015-01-01 00:00:00
abstract：:Minimal hepatic encephalopathy (MHE) is characterized by disturbance of mental state and neuromuscular function. To assess the clinical efficacy of acetyl-L: -carnitine (ALC) in the treatment of MHE, we performed a randomized, double-blind, placebo-controlled study administering ALC in cirrhotic patients with this dis...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章,随机对照试验
doi：10.1007/s10620-008-0238-6
更新日期：2008-11-01 00:00:00
abstract：:Radionuclide gastric solid-phase emptying was studied in 10 subjects with diabetic gastroparesis comparing the acute intravenous administration of cisapride (2.5, 5, 10 mg), placebo, and metoclopramide (10 mg). No hemodynamic or electrocardiographic changes were noted. While both cisapride and metoclopramide normalize...
journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章
doi：10.1007/BF01300277
更新日期：1992-07-01 00:00:00
abstract：:This study determined how the luminal surface hydrophobicity and transmucosal potential difference (PD) of canine gastric mucosa changed during the recovery period after the tissue was challenged with acidified aspirin. Luminal aspirin reduced both the contact angle and PD of mucosae incubated in Ussing chambers. Afte...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF02065551
更新日期：1995-06-01 00:00:00
abstract：:Two hundred one consecutive patients with gallstone disease who had undergone cholecystectomy were analyzed to determine the relative frequency of occurrence of cholesterol and pigment gallstones and to identify distinguishing features of the two stone types. Cholesterol stones (CS) formed the majority (94%) of gallst...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01300256
更新日期：1986-10-01 00:00:00
abstract：:We prospectively assessed the relationship between nodular gastritis and Helicobacter pylori infection. Of 1409 adults who underwent endoscopy for persistent dyspepsia between June 2004 and August 2005, 41 (2.9%) patients were diagnosed with nodular gastritis (11 [27%] men and 30 [73%] women). The mean age was 45.9 ye...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-006-9281-3
更新日期：2007-10-01 00:00:00
abstract：:Biliary mucin was isolated from human hepatic bile, and its induced effects on the appearance time of cholesterol monohydrate crystals (nucleation time) and on the precipitation of calcium carbonate were studied in vitro to examine the possible significance of mucin for ductular gallstone formation. Mucin was isolated...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01295919
更新日期：1993-05-01 00:00:00
abstract：:The aim of this study was to clarify the pathogenesis of Helicobacter pylori-negative duodenal ulcer (DU) by investigating the meal-stimulated serum gastrin (SG) response. The subjects were 9 patients with H. pylori-negative DU, 28 H. pylori-positive DU, 11 H. pylori-positive volunteers, and 30 H. pylori-negative volu...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1022808003014
更新日期：2003-04-01 00:00:00
abstract：BACKGROUND:The risk of pancreatic cancer is elevated among people with new-onset diabetes (NOD). Based on Rochester Epidemiology Project Data, the Enriching New-Onset Diabetes for Pancreatic Cancer (END-PAC) model was developed and validated. AIMS:We validated the END-PAC model in a cohort of patients with NOD using r...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-020-06139-z
更新日期：2021-01-01 00:00:00
abstract：:This study was designed to determine the possible effects of omeprazole on human natural killer cells. Peripheral venous blood samples were taken from 20 peptic ulcer patients before and at the 14th and the 28th days of omeprazole treatment. Mononuclear cells were removed from blood and their capability of making conj...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-007-9869-2
更新日期：2008-02-01 00:00:00
abstract：BACKGROUND/AIM:Familial Mediterranean fever (FMF), the most frequent periodic fever syndrome, is an autosomal recessive inherited disease that predominantly affects eastern Mediterranean populations. Fetuin-A is a well known negative acute-phase protein. Studies of this glycoprotein as a marker of inflammation in FMF a...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-013-2814-7
更新日期：2013-11-01 00:00:00
abstract：BACKGROUND:Repeated challenges of lipopolysaccharide (LPS) could reduce the expression of proinflammatory cytokines in vitro, and oral administration of ovalbumin (OVA) induces mucosal tolerance in vivo. However, the effect of local administration of LPS and OVA on experimental colitis in vivo remains unknown. AIMS:Th...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-011-1630-1
更新日期：2011-08-01 00:00:00
abstract：:Leptin is a 16-kDa nonglycosylated protein primarily secreted from the adipocytes of white fat; minor levels of regulated leptin expression also occurs at other sites such as placenta, skeletal muscle, the stomach fundus, and culture-activated hepatic stellate cells (HSCs). Leptin is primarily involved in the regulati...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章,评审
doi：10.1007/s10620-006-9126-0
更新日期：2006-10-01 00:00:00
abstract：:Changes in hepatic morphology were evaluated in 242 consecutive liver biopsy specimens obtained from nonalcoholic obese subjects. Steatosis occurred in 59.7% of the subjects but was moderate to severe in 28.7%. An alcoholic hepatitis-like picture was present in 8.7% and cirrhosis in 2.7%. Fibrosis of mild and moderate...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01308373
更新日期：1981-04-01 00:00:00
abstract：BACKGROUND:The chemokine SDF-1 and its receptor CXCR4 are essential for the proper functioning of multiple organs. In the liver, cholangiocytes and hepatic progenitor cells (HPCs) are the main cells that produce SDF-1, and SDF-1 is thought to be essential for HPC-stimulated liver regeneration. AIMS:In this study, CXCR...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-012-2239-8
更新日期：2012-11-01 00:00:00
abstract：:The effects of Sulglycotide were evaluated in a pilot study of active H. pylori+ atrophic gastritis. Ten informed patients (mean age 51 +/- 13 years) entered a double-blind study. Five received Sulglycotide 400 mg three times a day for one year, the other 5, placebo. At 0, 30, 90, 270, and 360 days of treatment, patie...
journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF02208579
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:The US Food and Drug Administration currently approves three types of anti-tumor necrosis factor α (anti-TNFα) therapy for treatment of moderate to severe Crohn's disease. There are no guidelines to clarify which of the drugs may be better suited to individual clinical scenarios. AIMS:We gathered national d...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-010-1530-9
更新日期：2011-04-01 00:00:00
abstract：INTRODUCTION:Crohn's disease (CD) follows a relapsing and remitting course incurring cumulative bowel damage over time. The question of whether or not the timing of the initiating biologic therapy affects long-term disease progression remains unanswered. Herein, we calculated rates of change in the Lémann index-which q...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-018-5434-4
更新日期：2019-11-01 00:00:00
abstract：:This study evaluated the gastroprotective activity of DA-6034 against various ulcerogens including ethanol, aspirin, indomethacin, stress, and acetic acid. The basic mechanisms of DA-6034 as a defensive factor such as mucus secretion and endogenous prostaglandin E(2) synthesis were determined. Rats with gastric lesion...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-006-9657-4
更新日期：2007-11-01 00:00:00
abstract：:A novel peptide, submandibular gland peptide-T (SGP-T), which reduces allergen-induced hypotension, was examined for effects on intestinal anaphylaxis. Hooded-Lister rats were sensitized to egg albumin and prepared for the measurement of in vivo myoelectric activity of the jejunum. The disruption of migrating myoelect...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1018847608184
更新日期：1997-11-01 00:00:00
abstract：:Published clinical trials (N = 56) of antisecretory drugs in the treatment of benign gastric ulcer were reviewed. Composite healing rates for various drug regimens were calculated using a method previously described for duodenal ulcer. Healing rates were compared with data on suppression of intragastric acidity to see...
journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章,评审
doi：10.1007/BF01798367
更新日期：1988-05-01 00:00:00
abstract：:Verapamil, a type-1 calcium-channel blocker, given intraperitoneally, macroscopically protected the gastric mucosa of rats from 96% ethanol-induced lesions in a dose-dependent fashion. This effect was significant when verapamil at 10 or 20 mg/kg was given 1 hr before ethanol. Histopathologically, verapamil prevented t...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01297083
更新日期：1993-11-01 00:00:00
abstract：BACKGROUND:Autofluorescence imaging (AFI), which is a "red flag" technique during Barrett's surveillance, is associated with significant false positive results. The aim of this study was to assess the inter-observer agreement (IOA) in identifying AFI-positive lesions and to assess the overall accuracy of AFI. METHODS:...
journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章
doi：10.1007/s10620-012-2358-2
更新日期：2013-02-01 00:00:00
abstract：:Gastroesophageal reflux may be responsible for atypical symptoms such as chronic cough and hoarseness. Our aim was to evaluate and treat patients with severe gastroesophageal reflux and chronic cough or hoarseness with intensive antireflux therapy. Twenty-seven patients with typical heartburn symptoms in addition to s...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF02064205
更新日期：1995-05-01 00:00:00
abstract：:A method for isolating and characterizing intestinal lymphoid cells from colonoscopic biopsies is presented. Intraepithelial lymphocytes were separated from the lamina propria by incubation in edetic acid (EDTA) and lamina propria lymphoid cells isolated by incubation in collagenase followed by Ficoll-Hypaque density ...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01300700
更新日期：1986-02-01 00:00:00
abstract：:The role of mucosal T-cell activation in HIV-associated enteropathy is uncertain. Twenty Zambian patients with AIDS and chronic diarrhea were studied, as were nine controls. Distal duodenal biopsies were taken at endoscopy. Morphometric analysis and dual color immunofluorescence staining were performed. Villous height...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1010738818127
更新日期：2001-05-01 00:00:00
abstract：:Over the past two decades, evidence has accumulated to challenge the traditional view that cardiac mucosa, which is comprised exclusively of mucus glands, is the normal lining of the most proximal portion of the stomach (the gastric cardia). There is now considerable evidence to suggest that cardiac mucosa develops as...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章,评审
doi：10.1007/s10620-018-5063-y
更新日期：2018-08-01 00:00:00
abstract：:To evaluate the frequency and type of gastroduodenal mucosal inflammatory changes in patients with symptomatic acid peptic disease and nonulcer dyspepsia, 100 patients with gastrointestinal symptoms indicative of acid peptic disease or dyspepsia and 10 control subjects were clinically evaluated and underwent radiograp...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01308325
更新日期：1980-09-01 00:00:00
abstract：:This study was undertaken to investigate the effect of ingestion of 80 g Vivonex on gallbladder volume, plasma cholecystokinin (CCK), and pancreatic polypeptide (PP) in eight healthy volunteers and to compare the results with those obtained after ingestion of 60 ml corn oil. Gallbladder volumes were measured by ultras...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01296686
更新日期：1987-01-01 00:00:00
abstract：:The present study reports the results of intravenous cyclosporine in 32 patients with refractory and/or severe attacks of ulcerative colitis (UC). Twenty of 32 patients responded to intravenous cyclosporine; cyclosporine was clinically effective and improved colonic lesions. However, one colonic perforation and one po...
journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章
doi：10.1007/BF02100145
更新日期：1996-12-01 00:00:00
