P3.J191: Impact of Obesity on Pediatric Inflammatory Bowel Disease: A National Inpatient Analysis

Background: The rate of childhood obesity is increasing in the United States, and this remains true even for children with inflammatory bowel disease. Although traditionally associated with weight loss, up to 23.6% of pediatric IBD patients in the U.S. are overweight or obese. Further investigation is needed to understand the interplay of these two comorbidities.

Objective:
Primary: To evaluate the differences in inpatient outcomes between pediatric IBD patients with obesity and pediatric IBD patients with healthy weights
Secondary: To compare demographic differences between pediatric IBD patients with obesity and pediatric IBD patients with healthy weights

Methods: Our retrospective cohort study analyzed all hospitalizations ≤ 21 years of age, with a primary discharge diagnosis of IBD (including Crohn’s Disease and Ulcerative Colitis) from the 2020 National Inpatient Sample, which yielded 2,259 patients. We excluded those with a BMI < 18.5, a BMI of 25-30, and those without a reported weight. The remaining hospital encounters were stratified into IBD with obesity (BMI ≥ 30) and IBD with healthy weight (BMI 18.5 – 24.9). Continuous variables were compared using t-tests and categorical variables with chi-square analysis. Post hoc analysis with Bonferroni correction was utilized to determine further statistical differences between categories.

Results: Our study included a total of 238 pediatric discharges, including 59 patients with obesity and 179 patients with healthy weights. IBD patients with obesity had statistically older ages of 17.7 ± 2.71 (p < 0.001) and consisted of more black patients (26.8% vs 10.2%, p< 0.011). There was no difference in gender, median household income, geographic location, or disease subtype. IBD patients with obesity had a statistically shorter length of hospital stay 4.94 ± 4.88 days (p < 0.001), a lower average total charge of $57,407 (p < 0.011), and less frequent need for parenteral nutrition (5.1% vs 20.1%, p< 0.007). There was no difference in the incidence of anemia, Vitamin D deficiency, C. diff infection, or surgery between both groups.

Conclusion: Our results demonstrate that children with IBD and obesity do not have worse hospital outcomes compared to IBD patients with healthy weights. Although there were no short-term increases in IBD-related inpatient complications, the long-term risks of obesity including hypertension, hyperlipidemia, and diabetes, were outside the scope of this study. In conclusion, pediatric IBD patients with obesity do not have more adverse inpatient outcomes compared to pediatric IBD patients with healthy weights during hospital admission.