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Post‐operative complications in elderly onset inflammatory bowel disease: a population‐based study
Author(s) -
Sacleux S.C.,
Sarter H.,
Fumery M.,
Charpentier C.,
GuillonDellac N.,
Coevoet H.,
Pariente B.,
PeyrinBiroulet L.,
GowerRousseau C.,
Savoye G.
Publication year - 2018
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14790
Subject(s) - medicine , incidence (geometry) , complication , inflammatory bowel disease , ulcerative colitis , adverse effect , surgery , cohort , disease , population , crohn's disease , cohort study , physics , environmental health , optics
Summary Background IBD diagnosed after the age of 60 is increasing. Data on post‐operative complications in elderly onset IBD are scarce. Aim To describe the incidence of and factors associated with post‐operative complications in elderly onset IBD , diagnosed after the age of 60. Methods Using EPIMAD Cohort (1988‐2006), among 841 incident IBD patients, 139 (17%) underwent intestinal surgery, including 100 Crohn's disease ( CD ) and 39 ulcerative colitis ( UC ). Results After a median post‐operative follow‐up of 6 years (2‐10), 50 (36%) patients experienced at least 1 complication with a total of 69. During the first 30 post‐operative days, the mortality rate was 4%. Thirty‐two early complications (<30 days) were observed in 23 patients (17%), with 15 infectious, without significant difference between CD and UC . More than half early post‐operative complications (n = 19, 59%) were severe (>grade 2) without significant difference between CD and UC ( P = 0.28). Thirty‐seven long‐term adverse effects of surgical therapy (≥30 days) were observed in 33 patients (24%). Multivariate analysis found (1) acute severe colitis ( OR = 7.84 [2.15‐28.52]) and emergency surgery ( OR = 4.46 [1.75‐11.36]) were associated with early post‐operative complications, and (2) Female gender ( HR = 2.10 [1.01‐4.37]) and delay before surgery >3 months ( HR = 2.09 [1.01‐4.31]) with long‐term adverse effects of surgical therapy. Conclusions One‐third of elderly IBD patients experienced at least 1 post‐operative complication. Half of the early complications were severe, and infectious. Emergency surgery was the key driver for post‐operative complication.