Increased Prevalence of Gastrointestinal, Cardiovascular, and Immunologic Conditions in Hospitalized Patients with Ehlers-Danlos Syndrome: A Case-Control Study

Overview

UConn Health, School of Medicine This study investigated the prevalence of gastrointestinal, cardiovascular, and immunologic conditions in hospitalized patients with Ehlers-Danlos syndrome (EDS), a group of rare, inherited connective tissue disorders. Small studies have suggested a potential link between EDS and these conditions, but this is the first large case - control study to be performed to date. It was hypothesized that an EDS diagnosis would be associated with a higher prevalence of gastrointestinal symptoms, cardiovascular autonomic dysfunction, food allergies, and cardiovascular complications compared to the general population of hospitalized patients. It was also hypothesized that EDS patients would have higher odds of mortality and likelihood of having a longer than average length of hospital stay (> 4 days). Cases and controls (matched 1:2) were acquired from the 2016 Nationwide Inpatient Sample. The study population included 6021 individuals (n=2007 EDS). On multivariate logistic regression analysis adjusted for confounders, EDS patients had significantly higher odds of having GI symptoms (Odds Ratio [OR] = 3.53, Confidence Interval [CI]: 3.08- 4.03, P < 0.0001), cardiovascular autonomic dysfunction (OR = 4.20, CI: 3.44- 5.14, P < 0.0001), food allergies (OR = 3.92, CI: 2.57-5.98, P < 0.0001), and cardiovascular complications (OR = 5.76, CI: 4.17-7.96, P < 0.0001). EDS patients were also 76% more likely to have a longer than average length of hospital stay (OR = 1.76, CI: 1.54-2.02, P < 0.0001). These findings will enable physicians to exercise proper precautions in treating EDS patients and provide rationale for EDS to be considered in patients with unexplained GI, cardiovascular, and immunologic manifestations.