Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu

被引：16

作者：

Jose Garcia, Maria ^{[1
]}

Rivero, Montserrat ^{[1
]}

Miranda-Bautista, Jose ^{[2
,3
]}

Baston-Rey, Iria ^{[4
]}

Mesonero, Francisco ^{[5
]}

Leo-Carnerero, Eduardo ^{[6
]}

Casas-Deza, Diego ^{[7
]}

Cagigas Fernandez, Carmen ^{[8
]}

Martin-Cardona, Albert ^{[9
]}

El Hajra, Ismael ^{[10
]}

Hernandez-Aretxabaleta, Nerea ^{[11
]}

Perez-Martinez, Isabel ^{[12
]}

Fuentes-Valenzuela, Esteban ^{[13
]}

Jimenez, Nuria ^{[14
]}

Rubin de Celix, Cristina ^{[15
]}

Gutierrez, Ana ^{[16
]}

Suarez Ferrer, Cristina ^{[17
]}

Maria Huguet, Jose ^{[18
]}

Fernandez-Clotet, Agnes ^{[19
]}

Gonzalez-Vivo, Maria ^{[20
]}

Del Val, Blanca ^{[21
]}

Castro-Poceiro, Jesus ^{[22
]}

Melcarne, Luigi ^{[23
]}

Duenas, Carmen ^{[24
]}

Izquierdo, Marta ^{[25
]}

Monfort, David ^{[26
]}

Bouhmidi, Abdel ^{[27
]}

Ramirez De la Piscina, Patricia ^{[28
]}

Romero, Eva ^{[29
]}

Molina, Gema ^{[30
]}

Zorrilla, Jaime ^{[31
]}

Calvino-Suarez, Cristina ^{[4
]}

Sanchez, Eugenia ^{[5
]}

Nunez, Andrea ^{[6
]}

Sierra, Olivia ^{[7
]}

Castro, Beatriz ^{[1
]}

Zabana, Yamile ^{[9
]}

Gonzalez-Partida, Irene ^{[10
]}

De la Maza, Saioa ^{[11
]}

Castano, Andres ^{[12
]}

Najera-Munoz, Rodrigo ^{[13
]}

Sanchez-Guillen, Luis ^{[32
]}

Castro, Micaela Riat ^{[15
]}

Luis Rueda, Jose ^{[17
]}

Manuel Benitez, Jose ^{[33
]}

Delgado-Guillena, Pedro ^{[34
]}

Tardillo, Carlos ^{[35
]}

Pena, Elena ^{[36
]}

Frago-Larramona, Santiago ^{[37
]}

Carmen Rodriguez-Grau, Maria ^{[38
]}

机构：

[1] Univ Cantabria, Hosp Univ Marques de Valdecilla, Inst Invest Sanitaria Valdecilla IDIVAL, Gastroenterol Dept, Santander 37008, Spain

[2] Univ Complutense, Hosp Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Gastroenterol Dept, Madrid 28009, Spain

[3] Univ Complutense, Dept Med, Madrid 28009, Spain

[4] Hosp Univ Clin Santiago, Gastroenterol Dept, Santiago De Compostela 15706, Spain

[5] Hosp Univ Ramon y Cajal, Gastroenterol Dept, Madrid 28034, Spain

[6] Hosp Univ Virgen del Rocio, Gastroenterol Dept, Seville 41013, Spain

[7] Hosp Univ Miguel Servet, Inst Invest Sanitaria Aragon IISA, Gastroenterol Dept, Zaragoza 50009, Spain

[8] Hosp Univ Marques de Valdecilla, Dept Gen & Digest Surg, Colorectal Unit, Santander 39008, Spain

[9] Hosp Univ Mutua Terrassa, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Terrassa 08221, Spain

[10] Hosp Univ Puerta de Hierro, Gastroenterol Dept, Majadahonda 28220, Spain

[11] Hosp Univ Basurto, Gastroenterol Dept, Bilbao 48013, Spain

[12] Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA 33, Dept Gastroenterol, Oviedo 33011, Spain

[13] Hosp Univ Rio Hortega, Gastroenterol Dept, Valladolid 47012, Spain

[14] Hosp Gen Univ Elche, Gastroenterol Dept, Alicante 03203, Spain

[15] Univ Autonoma Madrid UAM, Gastroenterol Dept, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP,Ctr Invest, Madrid 28006, Spain

[16] Hosp Gen Alicante, Gastroenterol Dept, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Alicante 03010, Spain

[17] Hosp Univ La Paz, Gastroenterol Dept, Madrid 28046, Spain

[18] Hosp Gen Univ Valencia, Gastroenterol Dept, Valencia 46014, Spain

[19] Hosp Clin Barcelona, Gastroenterol Dept, Barcelona 08036, Spain

[20] Hosp del Mar, Gastroenterol Dept, Barcelona 08003, Spain

[21] Hosp Rafael Mendez, Gastroenterol Dept, Lorca 30817, Spain

[22] Hosp St Joan Despi Moises Broggi, Gastroenterol Dept, Barcelona 08970, Spain

[23] Hosp Univ Parc Tauli, Gastroenterol Dept, Sabadell, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona 08208, Spain

[24] Hosp Univ Caceres, Gastroenterol Dept, Caceres 10003, Spain

[25] Hosp Univ Cabuenes, Gastroenterol Dept, Gijon 33203, Spain

[26] Consorcio Sanitario Terrasa, Gastroenterol Dept, Barcelona 08227, Spain

[27] Hosp Santa Barbara, Gastroenterol Dept, Puertollano 13500, Spain

[28] Hosp Univ Vitoria Gasteiz, Gastroenterol Dept, Vitoria 01002, Spain

[29] Hosp Clin Univ Valencia, Gastroenterol Dept, Valencia 46010, Spain

[30] Hosp Arquitecto Marcide, Gastroenterol Dept, Ferrol 15405, Spain

[31] Hosp Univ Gregorio Maranon, Dept Colorectal & Gastrointestinal Surg, Madrid 28009, Spain

[32] Hosp Gen Univ Elche, Dept Colorectal & Gastrointestinal Surg, Alicante 03203, Spain

[33] Hosp Reina Sofia, Gastroenterol Dept, IMIBIC, Cordoba 14004, Spain

[34] Hosp Gen Granollers, Gastroenterol Dept, Granollers 08042, Spain

[35] Hosp Nuestra Sanora de la Candelaria, Gastroenterol Dept, Tenerife 38010, Spain

[36] Hosp Royo Villanova, Gastroenterol Dept, Zaragoza 50007, Spain

[37] Complejo Hosp Soria, Gastroenterol Dept, Soria 42005, Spain

[38] Hosp Univ Henares, Gastroenterol Dept, Coslada 28002, Spain

[39] Hosp Univ Infanta Leonor, Gastroenterol Dept, Madrid 28031, Spain

[40] Complejo Hosp Univ Pontevedra, Gastroenterol Dept, Pontevedra 36071, Spain

[41] Hosp Alvaro Cunqueiro Vigo, Gastroenterol Dept, Vigo 36312, Spain

来源：

JOURNAL OF CLINICAL MEDICINE | 2021年 / 10卷 / 19期

关键词：

inflammatory bowel disease; Crohn's disease; ulcerative colitis; anti-TNF; ustekinumab; vedolizumab; postoperative complications; surgery; preoperative therapy; POSTOPERATIVE INFECTIOUS COMPLICATIONS; PREOPERATIVE STEROID USE; CROHNS-DISEASE; ULCERATIVE-COLITIS; RISK-FACTORS; GASTROINTESTINAL SURGERY; SURGICAL COMPLICATIONS; OUTCOMES; METAANALYSIS; RESECTION;

D O I：

10.3390/jcm10194402

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNE 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections.

引用

页数：17

共 61 条

[1] Corticosteroids and immunomodulators: Postoperative infectious complication risk in inflammatory bowel disease patients [J].