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Alimentary Tract| Volume 53, ISSUE 1, P54-60, January 2021

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Postoperative mortality after surgery for inflammatory bowel disease in the era of biological agents: A population-based study in Southern Europe

  • Montserrat Guasch
    Affiliations
    Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain

    Universitat Autònoma de Barcelona, Catalonia, Spain
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  • Emili Vela
    Affiliations
    Unitat d'Informació i Coneixement, Servei Català de la Salut, Generalitat de Catalunya, Catalonia, Spain
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  • Míriam Mañosa
    Affiliations
    Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain

    Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid Spain
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  • Montserrat Clèries
    Affiliations
    Unitat d'Informació i Coneixement, Servei Català de la Salut, Generalitat de Catalunya, Catalonia, Spain
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  • Fiorella Cañete
    Affiliations
    Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain

    Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid Spain
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  • David Parés
    Affiliations
    Universitat Autònoma de Barcelona, Catalonia, Spain

    Colorectal Surgery Unit, Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
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  • Àlex Guarga
    Affiliations
    Gerència de Serveis Assistencials, Àrea d'Atenció Sanitària, Servei Català de la Salut, Generalitat de Catalunya, Catalonia, Spain
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  • José Troya
    Affiliations
    Universitat Autònoma de Barcelona, Catalonia, Spain

    Colorectal Surgery Unit, Department of General Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
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  • Margalida Calafat
    Affiliations
    Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
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  • Eugeni Domènech
    Correspondence
    Corresponding author at: Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.
    Affiliations
    Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain

    Universitat Autònoma de Barcelona, Catalonia, Spain

    Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid Spain
    Search for articles by this author
Published:October 17, 2020DOI:https://doi.org/10.1016/j.dld.2020.09.026

      Abstract

      Background

      : Despite the efficacy of biological agents, surgery is still required for a large percentage of patients with inflammatory bowel disease (IBD).

      Aims

      To assess the postoperative mortality rates and associated risk factors in IBD patients in a population-based setting in the era of biological agents.

      Methods

      This is a population-based longitudinal study including all patients diagnosed with IBD in Catalonia who underwent intestinal resection or colectomy between 2007 and 2016, identified from the Catalan Health Surveillance System database. Logistic regression was used to calculate the adjusted odds ratio for postoperative in-hospital and 30-day mortality. Data for Crohn's disease (CD) and ulcerative colitis (UC) were analysed separately.

      Results

      A total of 1,660 interventions for CD (69%) and 738 for UC (31%) were performed at 55 centres. In-hospital and 30-day postoperative mortality rates were 2.1% and 2.5% for CD, and 5.4% and 6.4% for UC, respectively. In the multivariate logistic regression analysis, comorbidity was associated with in-hospital and 30-day postoperative mortality in CD and UC, whereas age was only associated with mortality in CD and a non-laparoscopic surgical approach with UC.

      Conclusions

      In the era of biologicals, the postoperative mortality rate for IBD depends mostly on co-morbidities and age.

      Keywords

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      Linked Article

      • Postoperative mortality after surgery for inflammatory bowel disease: The myth of Apollo and Artemis
        Digestive and Liver DiseaseVol. 53Issue 1
        • Preview
          In this issue Domènech et al. [1] investigated postoperative mortality after surgery for patients with inflammatory bowel disease (IBD) at the population level in Catalonia, Spain over 10 years (2007–2016). Hence, those data reflect contemporary care and include the liberal use of biological therapy. A multidisciplinary approach remains a mainstay of therapy in IBD. Surgical outcomes matter, as nearly every second patient with Crohn's disease (CD) requires surgical care, respectively every tenth patient with ulcerative colitis (UC) [2,3], in spite of the efficacy and availability of modern medical therapy.
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