World J Gastrointest Pathophysiol. 2024 Apr 22;15(1):92085. doi: 10.4291/wjgp.v15.i1.92085.

Dushyant Singh Dahiya ¹, Jennifer Wachala ², Shantanu Solanki ³, Dhanshree Solanki ⁴, Asim Kichloo ², Samantha Holcomb ², Uvesh Mansuri ⁵, Khwaja Saad Haq ⁶, Hassam Ali ⁷, Manesh Kumar Gangwani ⁸, Yash R Shah ⁹, Teresa Varghese ⁶, Hafiz Muzaffar Akbar Khan ¹⁰, Simon Peter Horslen ¹¹, Thomas D Schiano ¹², Syed-Mohammed Jafri ¹³

Author information

¹Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS 66160, United States. dush.dahiya@gmail.com.

²Department of Internal Medicine, Samaritan Medical Center, Watertown, NY 13601, United States.

³Division of Gastroenterology Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.

⁴Department of Medicine, Institute for Foreign Medical Graduate Education, Houston, TX 77030, United States.

⁵Department of Internal Medicine, MedStar Harbor Hospital, Baltimore, MD 21225, United States.

⁶Department of Internal Medicine, WellStar Spalding Regional Hospital, Griffin, GA 30224, United States.

⁷Division of Gastroenterology, Hepatology and Nutrition, East Carolina University/Brody School of Medicine, Greenville, NC 27858, United States.

⁸Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.

⁹Department of Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, MI 48341, United States.

¹⁰Division of Gastroenterology and Hepatology, SUNY Upstate Medical University, Syracuse, NY 13210, United States.

¹¹Department of Pediatrics, School of Medicine and UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15219, United States.

¹²Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.

¹³Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, MI 48202, United States.

Abstract

Background: Short bowel syndrome (SBS) hospitalizations are often complicated with sepsis. There is a significant paucity of data on adult SBS hospitalizations in the United States and across the globe.

Aim: To assess trends and outcomes of SBS hospitalizations complicated by sepsis in the United States.

Methods: The National Inpatient Sample was utilized to identify all adult SBS hospitalizations between 2005-2014. The study cohort was further divided based on the presence or absence of sepsis. Trends were identified, and hospitalization characteristics and clinical outcomes were compared. Predictors of mortality for SBS hospitalizations complicated with sepsis were assessed.

Results: Of 247097 SBS hospitalizations, 21.7% were complicated by sepsis. Septic SBS hospitalizations had a rising trend of hospitalizations from 20.8% in 2005 to 23.5% in 2014 (P trend < 0.0001). Compared to non-septic SBS hospitalizations, septic SBS hospitalizations had a higher proportion of males (32.8% vs 29.3%, P < 0.0001), patients in the 35-49 (45.9% vs 42.5%, P < 0.0001) and 50-64 (32.1% vs 31.1%, P < 0.0001) age groups, and ethnic minorities, i.e., Blacks (12.4% vs 11.3%, P < 0.0001) and Hispanics (6.7% vs 5.5%, P < 0.0001). Furthermore, septic SBS hospitalizations had a higher proportion of patients with intestinal transplantation (0.33% vs 0.22%, P < 0.0001), inpatient mortality (8.5% vs 1.4%, P < 0.0001), and mean length of stay (16.1 d vs 7.7 d, P < 0.0001) compared to the non-sepsis cohort. A younger age, female gender, White race, and presence of comorbidities such as anemia and depression were identified to be independent predictors of inpatient mortality for septic SBS hospitalizations.

Conclusion: Septic SBS hospitalizations had a rising trend between 2005-2014 and were associated with higher inpatient mortality compared to non-septic SBS hospitalizations.