Delayed Corticosteroid Treatment for Patients Requiring Hospitalization for Acute Inflammatory Bowel Disease Exacerbations Increases Length of Stay and Risk for Surgery in Crohn's Disease.

Jaya Vasudevan, Bhuvana Mukkamala, Bani Dhother, Paul Guzik, Zhouwen David Tang, Linda A Feagins

Abstract readMulticenter Study

In one paragraph

Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed

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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

Corticosteroid Initiation Before Antimicrobials Does Not Increase the Risk of Adverse Outcomes Among Individuals Hospitalized With an IBD Flare and Enteric Infection.Journal of clinical gastroenterology · 2026
Article

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5 · Who and what money

Authors and funding

6 authors.

Jaya VasudevanDepartment of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, TX, USA.

Bhuvana MukkamalaDepartment of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, TX, USA.

Bani DhotherDepartment of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, TX, USA.

Paul GuzikDepartment of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, TX, USA.

Zhouwen David TangDepartment of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, TX, USA.

Linda A FeaginsDepartment of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, TX, USA. linda.feagins@austin.utexas.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile corticosteroids are not recommended for maintenance of remission in inflammatory bowel disease (IBD), they are quite effective for the induction of remission for both Crohn's disease (CD) and ulcerative colitis (UC). We aimed to evaluate if a delay in starting corticosteroids after presentation to the hospital for an acute IBD exacerbation increased the likelihood of poor outcomes.

methodsRetrospective cohort study of IBD-related hospitalizations from 7 area hospitals in Austin, Texas between 2015 and 2020. Patients were included if admitted for an IBD flare and received corticosteroids. CD with intra-abdominal abscesses were excluded. Primary outcomes were length of stay (LOS), ICU stay, IBD-related surgery, and mortality.

resultsOf 478 inpatients, 311 (65%) received corticosteroids within 12 h of arrival. ICU stays (4.2% vs. 5.4%, p = 0.88, early vs. late corticosteroids) and inpatient mortality (1.0% vs. 1.8%, p = 0.75) were not significantly different between groups. However, after adjustment for confounders, LOS (4.7 vs. 5.8 days, p = 0.027) was significantly shorter and IBD-related surgery (3.5% vs. 7.2%, p = 0.048) was reduced for those receiving corticosteroids early. On subgroup analysis, these findings remained significant only for patients with CD and not UC.

conclusionsFor patients admitted with IBD flares without associated abscess, there was an increased LOS and increased risk for IBD-related surgery if corticosteroid therapy was delayed > 12 h after arrival. Guidelines recommend treating acute flares without delay, but guidance on specifics of timing is absent. Our data suggests that treatment should be started within 12 h of presentation, particularly for those with CD.

Indexed as

Adrenal Cortex HormonesColitis, UlcerativeCrohn DiseaseLength of StayTime-to-TreatmentAdultFemaleHospitalizationHospital MortalityHumansMaleMiddle AgedRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeAdrenal Cortex HormonesCorticosteroidsInflammatory bowel diseaseInpatient

Identifiers

PMID39948278

DOI10.1007/s10620-025-08907-1

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