Impact of Rheumatoid Arthritis on Hospitalized Inflammatory Bowel Disease Patients: Study of Demographics, Clinical Characteristics and Outcomes.

Background Inflammatory bowel disease (IBD), comprising ulcerative colitis and Crohn's disease gives rise to chronic intestinal inflammation. Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint and systemic inflammation. IBD is often linked with various autoimmune diseases, with RA being one of the most common. The coexistence of IBD and RA results in an increased inflammatory state, significantly compromising quality of life. Understanding the epidemiological and clinical characteristics of IBD patients with RA is essential for optimizing their management and improving outcomes. Methodology This retrospective observational study utilized data from the National Inpatient Sample (NIS) database from 2016 to 2020. Patients aged 18 years and older with a primary discharge diagnosis of IBD were included. This population was subdivided into two groups based on the presence and absence of RA. The primary objective was to compare outcomes between hospitalized IBD patients with and without RA. Key outcomes assessed included mortality rates, hospital length of stay (LOS), and total hospital charges. Secondary outcomes included the prevalence of comorbidities and IBD-related complications. Results From 2016 to 2020, a total of 455,655 hospitalized IBD patients were identified, among whom 10,590 (2.32%) had an underlying diagnosis of RA. Patients with both IBD and RA were significantly older than those without RA (mean age 52.21 vs. 45.72 years, p < 0.001) and had a higher proportion of females (72.51% vs. 53.27%, p < 0.01). RA patients exhibited a greater risk of cardiovascular risk factors compared to non-RA patients, including diabetes [adjusted odd ratio (aOR ) 1.12 (1.09-1.16)], hypertension [aOR 1.19 (1.07-1.33)], hyperlipidemia [aOR 1.61 (1.60-1.63)], chronic kidney disease stage 1-4 [aOR 1.35 (1.29-1.41)], coronary artery disease [aOR 1.67 (1.65-1.69)], and heart failure [aOR 1.45 (1.43-1.48)]. However, there were no significant differences in the rates of IBD-related complications or in-hospital mortality between the two groups. The mean hospital LOS was 5.15 days for RA patients and 4.95 days for non-RA patients (p = 0.08), with similar total hospital charges ($48,442.7 vs. $48,720.3, p = 0.88). Conclusion This study shows hospitalized IBD patients with and without RA have similar hospitalization outcomes, however, patients with RA have a higher cardiovascular risk. The findings emphasize the importance of integrated, multidisciplinary management approaches for these patients, addressing not only their gastrointestinal and rheumatologic conditions but also their associated comorbidities.