OP25 Biologics before surgery for IBD: Are they associated with post-operative infectious outcomes? Results from the national surgical quality improvement programme inflammatory bowel disease collaborative
S. Holubar1, X. Jai1, T. Hull1, N. Hyman2, S. Ramamoorthy3, S. Einsenstein3, National Surgical Quality Improvement Program Inflammatory Bowel Disease Collaborative
1Department of Colon and Rectal Surgery, Cleveland Clinic, Cleveland, USA, 2Department of Surgery, University of Chicago, Chicago, USA, 3Department of Surgery, University of California - San Diego, San Diego, USA
Background
We aimed to utilise the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Inflammatory Bowel Disease (IBD) Collaborative, which includes disease-specific variables, to assess the association between preoperative biologic exposure and post-operative infectious complications in the largest cohort reported to date.
Methods
Were obtained from ten IBD centres from 2017 - 2018. Univariate and multivariate analyses were performed, with any biologic use within 60-days of surgery as the primary predictor, adjusting for diagnosis, chronic steroid use, immunomodulator (IMM) use, ostomy construction, anaemia, malnutrition, operative length, emergency surgery, and other variables with
Results
A total of 1,562 patients were included, of which 832 (53%) were not exposed to biologics, and 730 (47%) were exposed to biologics before surgery. The biologics group had more preoperative weight loss, lower albumin, more systemic sepsis, more IMM and steroid use, and more had Crohn’s disease (all
Conclusion
In the largest retrospective cohort to date, we found that biologics exposure within 60 days of surgery for IBD, using a well-validated methodology and after vigorous adjustment for disease- and surgery-specific covariates, was not associated with post-operative infectious or surgical site infectious complications.