Impact of tobacco use on inpatient outcomes in inflammatory bowel disease: a retrospective matched cohort study.

4区医学

Annals of translational medicine Pub Date : 2026-02-28 Epub Date: 2026-02-25 DOI:10.21037/atm-25-141

Mohamed H Eldesouki, Mohammad Kloub, Abdul-Rahman I Abusalim, Mohammed Y Youssef, Mona T Ahmed, Khaled Elfert, Kanwarpreet Tandon

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Abstract

Background: Tobacco plays a complex role in patients with inflammatory bowel disease (IBD). Its impact on inpatient outcomes of IBD needs additional study. We aimed to assess the impact of smoking on clinical outcomes in hospitalized patients with IBD.

Methods: We conducted a retrospective cohort study using data from the National Inpatient Sample (NIS) spanning from 2016 to 2019. Patients with UC and CD were identified utilizing ICD-10 codes. Patients were stratified according to the smoking status in two groups. A propensity score matching was utilized to balance comorbidities between study groups. Study outcomes included rates of steroid use, surgeries, gastrointestinal (GI) bleeding, perianal abscess, and overall mortality. All outcomes were assessed during the index hospitalization. Statistical analysis was performed using Stata 17 software. Results were reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

Results: A total of 413,208 patients were included in our study, 180,558 patients had UC, and 232,650 patients had CD. After propensity score matching, we had a total of 151,106 patients: 39,616 patients had UC, with a total of 19,808 in each group. The CD patients were 111,490, with a total of 55,745 patients in each group. For UC patients, smokers had lower odds of steroid use (aOR =0.69, 95% CI: 0.61-0.79, P=0.001), and all-cause mortality (aOR =0.54, 95% CI: 0.32-0.96, P=0.03). For CD patients, smokers had higher odds of steroid use (aOR =1.13, 95% CI: 1.03-1.25, P=0.009), perianal abscess (aOR =1.12, 95% CI: 1.10-1.36, P=0.02), and all-cause mortality (aOR =1.51, 95% CI: 1.27-1.84, P=0.04). All other outcomes were not significant between the study cohorts.

Conclusions: Tobacco use in hospitalized patients with UC was associated with lower steroid use, while in patients with CD, it correlated with higher steroid use and increased odds of perianal abscesses. These findings highlight the complex impact of tobacco use on IBD outcomes.

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烟草使用对炎症性肠病住院患者预后的影响：一项回顾性匹配队列研究

背景：烟草在炎症性肠病（IBD）患者中起着复杂的作用。它对IBD住院结果的影响需要进一步的研究。我们的目的是评估吸烟对IBD住院患者临床结果的影响。方法：我们使用2016年至2019年国家住院患者样本（NIS）的数据进行了回顾性队列研究。使用ICD-10代码对UC和CD患者进行识别。根据吸烟情况将患者分为两组。使用倾向评分匹配来平衡研究组之间的合并症。研究结果包括类固醇使用率、手术、胃肠道（GI）出血、肛周脓肿和总死亡率。在指数住院期间评估所有结果。采用Stata 17软件进行统计分析。结果以校正优势比（aORs）和95%置信区间（CIs）进行报道。结果：我们的研究共纳入413208例患者，其中180558例为UC， 232650例为CD。经过倾向评分匹配后，我们共纳入151106例患者，其中39616例为UC，每组共19,808例。CD患者111490例，每组共55745例。对于UC患者，吸烟者使用类固醇的几率较低（aOR =0.69, 95% CI: 0.61-0.79， P=0.001），全因死亡率较低（aOR =0.54, 95% CI: 0.32-0.96， P=0.03）。对于乳糜泄患者，吸烟者使用类固醇（aOR =1.13, 95% CI: 1.03-1.25， P=0.009）、肛周脓肿（aOR =1.12, 95% CI: 1.10-1.36， P=0.02）和全因死亡率（aOR =1.51, 95% CI: 1.27-1.84， P=0.04）的几率更高。所有其他结果在研究队列之间无显著性差异。结论：UC住院患者的烟草使用与较低的类固醇使用相关，而CD患者的烟草使用与较高的类固醇使用和肛周脓肿发生率增加相关。这些发现强调了烟草使用对IBD结果的复杂影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of translational medicine Multiple-

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769

期刊介绍： The Annals of Translational Medicine (Ann Transl Med; ATM; Print ISSN 2305-5839; Online ISSN 2305-5847) is an international, peer-reviewed Open Access journal featuring original and observational investigations in the broad fields of laboratory, clinical, and public health research, aiming to provide practical up-to-date information in significant research from all subspecialties of medicine and to broaden the readers’ vision and horizon from bench to bed and bed to bench. It is published quarterly (April 2013- Dec. 2013), monthly (Jan. 2014 - Feb. 2015), biweekly (March 2015-) and openly distributed worldwide. Annals of Translational Medicine is indexed in PubMed in Sept 2014 and in SCIE in 2018. Specific areas of interest include, but not limited to, multimodality therapy, epidemiology, biomarkers, imaging, biology, pathology, and technical advances related to medicine. Submissions describing preclinical research with potential for application to human disease, and studies describing research obtained from preliminary human experimentation with potential to further the understanding of biological mechanism underlying disease are encouraged. Also warmly welcome are studies describing public health research pertinent to clinic, disease diagnosis and prevention, or healthcare policy.  With a focus on interdisciplinary academic cooperation, ATM aims to expedite the translation of scientific discovery into new or improved standards of management and health outcomes practice.