Browsing by Author "Mokricka, Viktorija"

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    Burden of extraintestinal manifestations and comorbidities in treated and untreated ulcerative colitis and Crohn’s disease : a Latvian nationwide prescription database study 2014–2019
    (2022-12-01) Teterina, Irēna; Mokricka, Viktorija; Petrošina, Eva; Pokrotnieks, Juris; Faculty of Pharmacy; Faculty of Medicine
    Inflammatory bowel diseases (IBD) are frequently accompanied by extraintestinal manifestations (EIMs) due to systemic autoimmune processes, which are important in the management of IBD patients and their long-term outcomes. The aim of the study was to determine the occurrence of EIMs comorbidities and their burden in IBD patients, based on the Latvian nationwide reimbursed prescription database from 2012 till 2019. Incident Crohn's disease (CD) and ulcerative colitis (UC) patients between 2014 and 2018 were matched on age and sex with non-treated IBD controls and followed up until 2019. EIMs were selected based on a previously used methodology and grouped into organ systems. The cohort was tested for differences in the timing and occurrence of EIMs, as well as overall cumulating disease burden. The study population included 187 CD and 1137 UC patients. Higher prevalence of EIMs was observed in untreated IBD patients, whereas in the treated IBD patient group prevalence remained numerically similar. Among treated patients, the most common EIMs affected cardiovascular, hepatopancreatobiliary, endocrine, musculoskeletal, respiratory, and the skin and intestinal tract systems, where 28.4-79.9% of IBD patients experienced these EIMs for the first time before their IBD diagnosis. The treated female IBD patients tended to have higher frequency of EIMs compared to male patients. The overall comorbidity burden trend increased with time. The study provides evidence that treated IBD patients have lower risk for EIMs/comorbidities compared to untreated IBD patients.
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    CORRELATION OF INTESTINAL ULTRASOUND DATA WITH LABORATORY MARKERS OF INFLAMMATION FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE
    (2024-08) Jevdokimova, Natālija; Jevdokimov, Denis; Teterina, Irena; Pokrotnieks, Juris; Puķītis, Aldis; Mokricka, Viktorija; Faculty of Pharmacy; Faculty of Medicine
    Intestinal ultrasound is a new non-invasive imaging method that can be used for diagnostics of inflammatory bowel disease, to evaluate the response to therapy, and monitor serious complications of the disease in time. A prospective study was performed in Pauls Stradiņš Clinical University Hospital. Thirty patients were enrolled in the study: 21 patients with ulcerative colitis and 9 patients with Crohn’s disease. Intestinal ultrasound was performed using Diagnostic Ultrasound System Arietta S70 (Hitachi, Japan). Intestinal wall structure (thickness), blood flow (Limberg score), intraluminal content, mesenteric fat hypertrophy and lymph nodes were evaluated, and laboratory markers of inflammation and clinical activity indices were analysed. Increased bowel wall thickness (BWT) (3 3 mm) was detected in 22 patients (73.3%), and wall stratification in 17 patients (56.7%). Using statistical analysis, it was concluded that there was a positive and statistically significant correlation between bowel wall thickness and ferritin (r = 0.60; p < 0.001), CRP (r = 0.49, p = 0.006), and faecal calprotectin (r = 0.84, p < 0.001). Intestinal ultrasound is a promising real time monitoring method for both Crohn’s disease and ulcerative colitis, which showed statistically significant correlations between bowel wall thickness, bowel wall stratification, blood flow, laboratory markers of inflammation and clinical activity indices.
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    National 30-Day Readmission Trends in IBD 2014-2020 - Are We Aiming for Improvement?
    (2024-08-13) Teterina, Irēna; Mirzajanova, Veronika; Mokricka, Viktorija; Zolovs, Maksims; Šmits, Dins; Pokrotnieks, Juris; Department of Pharmacology; Statistics Unit; Department of Public Health and Epidemiology; Department of Internal Diseases
    Background: Inflammatory bowel disease (IBD) prevalence in Eastern Europe is increasing. The 30-day readmission rate is a crucial quality metric in healthcare, reflecting the effectiveness of initial treatment and the continuity of care post-discharge; however, such parameters are rarely analyzed. The aim of this study was to explore the trends in 30-day readmissions among patients with inflammatory bowel disease in Latvia between 2014 and 2020.  Methods: This is a retrospective trends study in IBD-ulcerative colitis and Crohn's disease (UC and CD)-patients in Latvia between 2014 and 2020, involving all IBD patients identified in the National Health service database in the International Classification of Diseases-10 (ICD) classification (K50.X and K51.X) and having at least one prescription for IBD diagnoses. We assessed all IBD-related hospitalizations (discharge ICD codes K50X and K51X), as well as hospitalizations potentially related to IBD comorbidities. We analyzed hospitalization trends and obtained the 30 day all-cause readmission rate, disease specific readmission rate and readmission proportion for specific calendar years. Trends in readmissions and the mean length of stay (LOS) for CD and UC were calculated.  Results: Despite a decrease in admission rates observed in 2020, the total number of readmissions for CD and UC has increased. Female patients prevailed through the study period and were significantly older than male patients in both the CD and UC groups, p < 0.05. We noted that there was no trend for 30 day all-cause readmission rate for CD ( p > 0.05); however, there was a statistically significant trend for 30 day all-cause readmission for UC patients ( p-trend = 0.018) in the period from 2014 to 2019. There was a statistically significant trend for CD-specific readmission rate ( p < 0.05); however, no statistically significant trend was observed for UC-specific readmission ( p > 0.05). An exploratory analysis did not reveal any statistically significant differences between treated and not-treated IBD patients ( p > 0.05). The increasing trend is statistically significant over the period 2014-2018 ( p < 0.05); however, the trend interrupts in 2020, which can be associated with the COVID-19 global pandemic and the related changes in admission flows where the gastroenterology capacity was reallocated to accommodate increasing numbers of COVID-19 patients. More studies are needed to evaluate the long-term impact of COVID-19 pandemic and 30-day readmissions. No significant dynamics were observed in the mean total hospitalization costs over the 2014-2020 period.