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Study identifies predictors of complications following intestinal resection for IBD

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LAS VEGAS — Advanced age, open surgical procedures and multiple comorbidities were predictive of postoperative complications after intestinal resection among patients with IBD in a study presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.

The study included data on 3,197 patients hospitalized for intestinal resection because of either Crohn’s disease (n=2,638) (CD) or ulcerative colitis (n=559) (UC) at facilities throughout Alberta, Canada, between 2002 and 2011. Researchers identified incidence of in-hospital postoperative complications and evaluated potential predictive factors, including age, type of admission, the surgical technique used and the number of comorbidities. Readmission incidence within 30, 60 and 90 days also was observed.

In-hospital postoperative complications occurred in 36% of CD cases and 34% of UC cases. The most common complications included gastrointestinal issues (67.5% of CD cases; 65.8% of UC), such as intestinal obstructions (15.1% of CD cases; 23.1% of UC); infections (26.5% of CD; 33.7% of UC), and wounds (26.2% of CD; 33.7% of UC) such as fistula (12.8% CD; 2.5% UC) or accidental punctures or lacerations (9.4% CD; 12.6% UC) sustained during the procedure.

Investigators observed significant associations between risk for postoperative complications and age older than 65 years in CD and UC cases (RR=1.47, 1.02-2.10 for CD; RR=2.56, 1.23-5.29 for UC), along with elective as opposed to emergent admission, and open surgical procedures as opposed to laparoscopy (P<.03 for both). The presence of three or more comorbidities was associated with increased complication risk in patients with CD (RR=1.40, 1.06-1.87 for CD), but not UC.

Patients with CD were readmitted to the hospital within 30 days in 9% of cases, within 60 days in 11% of cases and within 90 days in 13% of cases. Of these patients, 59% were admitted for a postoperative complication. Patients with UC had fewer instances of readmission (7% at 30 days, 10% at 60 days and 13% at 90 days), and 55% of those admitted had a postoperative complication diagnosis.

Alexandra D. Frolkis

“We’ve identified certain risk factors for in-hospital complications after an intestinal resection surgery for Crohn’s disease or ulcerative colitis,” researcher Alexandra D. Frolkis, BSc, a PhD student at the University of Calgary, told Healio.com. “If you’re able to plan ahead and identify a patient who’s about to go into surgery, and go for a laparoscopic surgery, that’s best.”

For more information:

Frolkis AD. P953: Postoperative Complications in Crohn’s Disease and Ulcerative Colitis Patients: A Province-wide Cohort Study. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.