No difference in postoperative outcome after acute surgery whether the patients presented for first time or are known with Crohn's disease

Abstract

PurposesAcute operations (within 48 h) or urgent (within 2–7 days) carry the risk of unfavorable outcome as the patient is not optimized, the operation is performed by trainees and the disease is severe necessitating acute/urgent intervention. However, Crohn's disease (CD) patients who present as acute disease may have more favorable outcome because they did not receive medications, surgery is performed early and the disease is promptly controlled. AimTo investigate whether CD patients presented first time have more favorable outcome compared to those who are known with CD. MethodRetrospective multi-center study. Rate of complications, duration of hospitalization and rate of re-admission were used as a measure of postoperative outcome. Univariate and multi-variate analyses were used. ResultsSixty-one patients in whom acute CD was first presentation (group 1) did not have more favorable outcome compared to 167 patients known to have CD (group 2) and presented acute. Mean duration of hospitalization was 8.7 days in group 1 compared to 9.4 days in group 2. Complications occurred in 12/61 patients (19.7%) in group 1 compared to 39/167 patients (23.4%) in group 2: odds ratio 1 .113, CI [0.611–2.024]. No difference in intra-abdominal septic complications rate was found between the two groups: odds ratio 0.932, CI [0.369–2.355]. Re-admission was seen in six patients (9.8%) in group 1 vs. 23 (13.8%) in Group 2: odds ratio 1.464, CI [0.566–3.788]. ConclusionPatients undergoing acute surgery for the first CD presentation did not have more favorable outcome compared to those undergoing acute intestinal resection for known CD.