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Clinical And Epidemiological Characteristics Of Microscopic Colitis: Analysis Study Of National Inpatient Sample (Nis) 2016

The American Journal of Gastroenterology(2020)

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摘要
INTRODUCTION: Microscopic colitis (MC) is an inflammatory condition of unclear etiology characterized by colonic mucosal lymphocytic infiltrate with intraepithelial lymphocytes ≥ 20 per 100 enteric surface cells (lymphocytic colitis subtype) or a typical subepithelial collagen layer whose thickness is ≥ 10 μm (collagenous colitis subtype). Patients usually report chronic watery diarrhea, abdominal pain, weight loss, and fatigue; and it frequently impacts the quality of life. The majority of cases are managed as outpatient, yet sometimes it can result in severe symptoms requiring hospital admission. We aim to identify the clinical and epidemiologic characteristics of Mc that require hospital admission. METHODS: The Health Care and Utilization Project National Inpatient Sample (HCUP-NIS) 2016 database was searched for admissions for MC. We investigated different epidemiological and clinical characteristics. All statistical analyses were done using IBM SPSS Statistics TM version 25.0 (IBM Corporation, Artmonk, NY). RESULTS: From a total of more than 7-million admissions, we identified only 54 hospital admissions for MC. Mean age was 66.7 years (95% CI 61.8–71.6 years) and differed between females and males (63.5 vs 77 years, P = 0.003). Around 76% of admissions were for female patients (n = 41). Racial differences were noticed with white being predominant (89%, n = 48). Mean length of stay was 5.6 days (95% CI 4.8–6.5), and none of the patients died in the hospital. Of interest, seventy two percent of admissions were in the New England and Middle Atlantic States (n = 39). In addition, all the admissions occurred between September and December (n = 54). The most commonly associated comorbidities were nicotine dependence (62.9%, n = 34), hypertension (57%, n = 31), gastroesophageal reflux disease (46%, n = 25), major depressive disorder (27%, n = 15), hyperlipidemia (27%, n = 15), and anxiety (25%, n = 14). Most common reported inpatient complications were hypokalemia (50%, n = 27), dehydration (41%, n = 22), acute kidney failure (24%, n = 13), and hypomagnesemia (20%, n = 11). CONCLUSION: Microscopic colitis either rarely requires inpatient admission or is underdiagnosed medical entity. Female, white race, and old age were the predominant epidemiologic characteristics. All the admissions occurred during wintertime, and the majority were admitted to hospitals in New England and Middle Atlantic areas. Smoking, hypertension, major depression disorder, and anxiety were commonly associated with MC.
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关键词
microscopic colitis,national inpatient sample,epidemiological characteristics
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