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Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study

Patients with inflammatory bowel disease often present to the emergency department due to the chronic relapsing nature of the disease. Previous studies have shown younger patients to have an increased frequency of emergency department visits, resulting in repeated exposure to imaging studies and ste...

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Autores principales: Euers, Lindsay, Abughazaleh, Shaadi, Glassner, Kerri, Gajula, Prianka, Jones-Pauley, Michelle, Ezeana, Chika, Puppala, Mamta, Wang, Lin, Wong, Stephen, Oglat, Ayah, Nickerson, Stephanie, Abraham, Bincy P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234275/
https://www.ncbi.nlm.nih.gov/pubmed/34204580
http://dx.doi.org/10.3390/jcm10122679
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author Euers, Lindsay
Abughazaleh, Shaadi
Glassner, Kerri
Gajula, Prianka
Jones-Pauley, Michelle
Ezeana, Chika
Puppala, Mamta
Wang, Lin
Wong, Stephen
Oglat, Ayah
Nickerson, Stephanie
Abraham, Bincy P.
author_facet Euers, Lindsay
Abughazaleh, Shaadi
Glassner, Kerri
Gajula, Prianka
Jones-Pauley, Michelle
Ezeana, Chika
Puppala, Mamta
Wang, Lin
Wong, Stephen
Oglat, Ayah
Nickerson, Stephanie
Abraham, Bincy P.
author_sort Euers, Lindsay
collection PubMed
description Patients with inflammatory bowel disease often present to the emergency department due to the chronic relapsing nature of the disease. Previous studies have shown younger patients to have an increased frequency of emergency department visits, resulting in repeated exposure to imaging studies and steroids, both of which are associated with risks. We performed a retrospective cohort analysis of inflammatory bowel disease patients seen at Houston Methodist Hospital’s emergency department from January 2014 to December 2017 using ICD codes to identify patients with Crohn’s disease, ulcerative colitis, or indeterminate colitis from the electronic medical record. Data were collected on demographics, medications, and imaging. Five hundred and fifty-nine patients were randomly selected for inclusion. Older age was associated with decreased risk of CT scan or steroid use. Patients with ulcerative colitis compared to Crohn’s had decreased risk of CT scan, while there was an increased risk of CT in patients on a biologic, immunomodulator, or when steroids were given. Steroid use was also more common in those with inflammatory bowel disease as the primary reason for the visit. Patients in our study frequently received steroids and had CT scans performed. The increased risk of CT in those on a biologic, immunomodulator, or steroids suggests more severe disease may contribute. Guidelines are needed to reduce any unnecessary corticosteroid use and limit repeat CT scans in young inflammatory bowel disease patients to decrease the risk of radiation-associated malignancy over their lifetime.
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spelling pubmed-82342752021-06-27 Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study Euers, Lindsay Abughazaleh, Shaadi Glassner, Kerri Gajula, Prianka Jones-Pauley, Michelle Ezeana, Chika Puppala, Mamta Wang, Lin Wong, Stephen Oglat, Ayah Nickerson, Stephanie Abraham, Bincy P. J Clin Med Article Patients with inflammatory bowel disease often present to the emergency department due to the chronic relapsing nature of the disease. Previous studies have shown younger patients to have an increased frequency of emergency department visits, resulting in repeated exposure to imaging studies and steroids, both of which are associated with risks. We performed a retrospective cohort analysis of inflammatory bowel disease patients seen at Houston Methodist Hospital’s emergency department from January 2014 to December 2017 using ICD codes to identify patients with Crohn’s disease, ulcerative colitis, or indeterminate colitis from the electronic medical record. Data were collected on demographics, medications, and imaging. Five hundred and fifty-nine patients were randomly selected for inclusion. Older age was associated with decreased risk of CT scan or steroid use. Patients with ulcerative colitis compared to Crohn’s had decreased risk of CT scan, while there was an increased risk of CT in patients on a biologic, immunomodulator, or when steroids were given. Steroid use was also more common in those with inflammatory bowel disease as the primary reason for the visit. Patients in our study frequently received steroids and had CT scans performed. The increased risk of CT in those on a biologic, immunomodulator, or steroids suggests more severe disease may contribute. Guidelines are needed to reduce any unnecessary corticosteroid use and limit repeat CT scans in young inflammatory bowel disease patients to decrease the risk of radiation-associated malignancy over their lifetime. MDPI 2021-06-17 /pmc/articles/PMC8234275/ /pubmed/34204580 http://dx.doi.org/10.3390/jcm10122679 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Euers, Lindsay
Abughazaleh, Shaadi
Glassner, Kerri
Gajula, Prianka
Jones-Pauley, Michelle
Ezeana, Chika
Puppala, Mamta
Wang, Lin
Wong, Stephen
Oglat, Ayah
Nickerson, Stephanie
Abraham, Bincy P.
Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study
title Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study
title_full Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study
title_fullStr Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study
title_full_unstemmed Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study
title_short Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study
title_sort risk factors for and frequency of ct scans, steroid use, and repeat visits in inflammatory bowel disease patients seen at a single-center emergency department: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234275/
https://www.ncbi.nlm.nih.gov/pubmed/34204580
http://dx.doi.org/10.3390/jcm10122679
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