Clinical Impact of Primary Sclerosing Cholangitis on Outcomes of Inflammatory Bowel Disease Hospitalization: A Propensity Score Matching Analysis of the Nationwide Inpatient Sample

Abstract

Objective: We aimed to evaluate the effect of primary sclerosing cholangitis (PSC) on hospitalization outcomes of inflammatory bowel disease (IBD) patients.

Methods: This retrospective study used data from the Nationwide Inpatient Sample (NIS) database from January 1, 2019, to December 31, 2020, including adults (≥ 18 years) admitted and diagnosed with IBD. Key outcomes included length of hospital stay (LOS), in-hospital mortality, hospitalization cost, and complications. The propensity score matching (PSM) analysis was used to balance characteristics between IBD patients with and without PSC, followed by logistic regression for analysis.

Results: After PSM analysis, 4950 patients (PSC: 990; non-PSC: 3960) were analyzed. IBD patients with PSC showed higher odds of any complication (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.80–2.39), including acute kidney injury (OR 1.31, 95% CI 1.10–1.55), septic shock (OR 1.84, 95% CI 1.33–2.54), liver cirrhosis (OR 18.19, 95% CI 14.23–23.25), and liver failure (OR 8.33, 95% CI 5.93–11.70) (all p < 0.05). These associations were consistently observed across subgroups with stronger associations in the Crohn's disease subgroup.

Conclusions: PSC significantly increases the risk of short-term complications in hospitalized IBD patients and the likelihood of chronic liver disease-related complications. These findings highlight the need for targeted management strategies for IBD patients with co-existing PSC.

Keywords

inflammatory bowel diseases / nationwide inpatient sample / propensity score matching analysis / sclerosing cholangitis

RIGHTS & PERMISSIONS

2025 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.