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P-099 Geriatric Patients with Inflammatory Bowel Disease Receive More Imaging Studies than Younger Patients with Inflammatory Bowel Disease

BACKGROUND: Inflammatory bowel disease (IBD) affects approximately 1.4 million people in North America. Due to the natural history of the disease and its episodic course, patients typically undergo numerous imaging studies to evaluate the disease status. As treatment options have improved, patients with IBD have less morbidity and mortality resulting in an increasing number of elderly patients with IBD. There is limited information regarding the management of the geriatric population. This study evaluated the frequency of imaging studies in the geriatric and younger IBD patients. METHODS: A retrospective medical record review of IBD patients managed at an urban university was performed using a multispecialty electronic health record. All patients with IBD, age ≥18, were included. There were no exclusion factors. Patient gender, disease type, and total imaging studies during a 42-month period were obtained. Total imaging included radiographs, CT scans, MRIs and ultrasounds. A database, maintaining patient confidentiality, was created. Statistical analysis was performed using unpaired t-test with significance set at P < 0.05. The university institutional review board approved the study. RESULTS: Three hundred fifteen medical records were reviewed. One hundred seventy-one patients had Crohn's disease, 142 patients had ulcerative colitis, and 2 patients had indeterminate IBD. There were 189 women (174 <65, 15 ≥65 years) and 126 men (117 <65, 9 ≥65 years). Two hundred ninety-one patients were <65 years (with a mean age of 41.5 years), and 24 patients were ≥65 (with a mean age of 72.5 years). Patients ≥65 years had 1.9 times more imaging studies than patients <65 years (9.5 compared to 5.1, P = 0.04, CI −8.5595 to −0.3005). Gender evaluation revealed that women ≥65 years had 2.9 times more imaging than women <65 years (P = 0.005). In contrast, although ≥65 year old males had 1.3 times more imaging than <65 year old males, this value did not reach statistical significance (P = 0.51). Notably, imaging evaluation limited to abdominal studies revealed that patients ≥65 years received 1.5 times more abdominal imaging than patients <65 years which did not reach statistical significance (P = 0.34). CONCLUSIONS: All patients with IBD underwent frequent radiology studies (5.44 images per patient), and specifically had a high number of abdominal imaging (1.53 images per patient). This study revealed a statistical difference between the amounts of total imaging performed in the geriatric IBD population compared to the younger IBD population. However, there was no significant difference in the amount of abdominal imaging. This may indicate that IBD activity prompting diagnostic radiology studies is similar in older and younger patients. However, it is evident that geriatric patients, specifically females, receive significantly more total imaging studies, which may reflect the development of co-morbidities that affect older populations. It is important to remain judicious in ordering imaging studies and limiting radiation exposure incurred by inflammatory bowel disease patients.