Variation in Surgical Outcomes for Adolescents and Young Adults with Inflammatory Bowel Disease

Surgical complications vary by hospital setting and surgeon’s specialty.

Some 1 million to 1.5 million adolescents and young adults are affected by inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. Complications of IBD often necessitate surgery, and with it, complications.

Investigators used data on 500 hospitals for all patients 16 to 25 years old with IBD who had bowel surgery (2007–2009) to examine how surgical complications differed by hospital type and surgeon specialty.

Study participants were mean age 21 years; 71 percent had Crohn’s disease, 28 percent ulcerative colitis, and 9 percent both diagnoses. Surgeries performed in children’s hospitals had higher rates of complications—35 percent of children’s hospital patients had one or more surgical complications—compared to 26 percent of those admitted to general hospitals. Surgeries performed by pediatric surgeons, however, had the lowest complication rates at 11 percent, compared to 29 percent for general surgeons, and 27 percent for colorectal surgeons.

The researchers are unsure why such differences were observed and note that the availability of pediatric subspecialties may not benefit adolescents or young adult patients.

“These findings support the need for better understanding of quality of care variations across different hospital settings,” they write, “particularly for youth of transitional age who are traversing both pediatric and adult systems of care.”