Association between preoperative biologic use and surgical morbidity in patients with Crohn's disease
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
PURPOSE: We evaluated the influence of preoperative treatments with biologics on surgical morbidity in patients with Crohn's disease (CD).
METHODS: We reviewed the surveillance data of patients with CD who underwent surgery between April 2018 and April 2021. The possible risk factors for morbidity were analyzed.
RESULTS: A total of 305 surgically treated patients were included. Anti-TNF alpha agents and ustekinumab were used in 92 and 27 patients, respectively, within 12 weeks before surgery. There were no cases of mortality. In total, 70/305 (23.0%) patients developed a complication, and 42/305 (13.8%) patients developed a surgical site infection (SSI) (17 incisional SSIs and 35 organ/space SSIs). Current smoking status (OR 3.44), emergent/urgent surgery (OR 6.85), and abdominoperineal resection (APR) (OR 14.93) were identified as risk factors for total complications. Penetrating disease (OR 14.55) was identified as a risk factor for incisional SSIs. Current smoking status (OR 7.09), an American Society of Anesthesiologists (ASA) score greater than 3 (OR 5.85), a postoperative blood sugar level over 155 mg/dL (OR 4.37), and APR (OR 207.95) were identified as risk factors for organ/space SSIs.
CONCLUSIONS: No correlation between preoperative treatment with biologics and surgical mortality or morbidity was found. However, we should perform further analyses on a larger number of patients because the analyses may be limited by selection bias for treatment and several confounding factors.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
International journal of colorectal disease - 37(2022), 5 vom: 06. Mai, Seite 999-1010 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Uchino, Motoi [VerfasserIn] |
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| Links: |
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| Themen: |
Biological Products |
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| Anmerkungen: |
Date Completed 09.05.2022 Date Revised 09.05.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00384-022-04140-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM339142561 |
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| 245 | 1 | 0 | |a Association between preoperative biologic use and surgical morbidity in patients with Crohn's disease |
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| 520 | |a © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a PURPOSE: We evaluated the influence of preoperative treatments with biologics on surgical morbidity in patients with Crohn's disease (CD) | ||
| 520 | |a METHODS: We reviewed the surveillance data of patients with CD who underwent surgery between April 2018 and April 2021. The possible risk factors for morbidity were analyzed | ||
| 520 | |a RESULTS: A total of 305 surgically treated patients were included. Anti-TNF alpha agents and ustekinumab were used in 92 and 27 patients, respectively, within 12 weeks before surgery. There were no cases of mortality. In total, 70/305 (23.0%) patients developed a complication, and 42/305 (13.8%) patients developed a surgical site infection (SSI) (17 incisional SSIs and 35 organ/space SSIs). Current smoking status (OR 3.44), emergent/urgent surgery (OR 6.85), and abdominoperineal resection (APR) (OR 14.93) were identified as risk factors for total complications. Penetrating disease (OR 14.55) was identified as a risk factor for incisional SSIs. Current smoking status (OR 7.09), an American Society of Anesthesiologists (ASA) score greater than 3 (OR 5.85), a postoperative blood sugar level over 155 mg/dL (OR 4.37), and APR (OR 207.95) were identified as risk factors for organ/space SSIs | ||
| 520 | |a CONCLUSIONS: No correlation between preoperative treatment with biologics and surgical mortality or morbidity was found. However, we should perform further analyses on a larger number of patients because the analyses may be limited by selection bias for treatment and several confounding factors | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Biologics | |
| 650 | 4 | |a Crohn’s disease | |
| 650 | 4 | |a Morbidity | |
| 650 | 4 | |a Surgery | |
| 650 | 4 | |a Surgical site infection | |
| 650 | 7 | |a Biological Products |2 NLM | |
| 650 | 7 | |a Tumor Necrosis Factor Inhibitors |2 NLM | |
| 700 | 1 | |a Ikeuchi, Hiroki |e verfasserin |4 aut | |
| 700 | 1 | |a Horio, Yuki |e verfasserin |4 aut | |
| 700 | 1 | |a Kuwahara, Ryuichi |e verfasserin |4 aut | |
| 700 | 1 | |a Minagawa, Tomohiro |e verfasserin |4 aut | |
| 700 | 1 | |a Kusunoki, Kurando |e verfasserin |4 aut | |
| 700 | 1 | |a Goto, Yoshiko |e verfasserin |4 aut | |
| 700 | 1 | |a Beppu, Naohito |e verfasserin |4 aut | |
| 700 | 1 | |a Ichiki, Kaoru |e verfasserin |4 aut | |
| 700 | 1 | |a Ueda, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Nakajima, Kazuhiko |e verfasserin |4 aut | |
| 700 | 1 | |a Ikeda, Masataka |e verfasserin |4 aut | |
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