P155 Predictive factors of post-operative septic complications in Crohn’s disease: A single-centre study

Abstract

Surgical treatment is unavoidable in most Crohn’s disease (CD) patients despite the efficacy of medical treatment especially biotherapies. The aim of our study was to evaluate the effects of immunosuppressive and immunomodulatory drugs on post-surgical outcomes in CD and assess the predictive factors of septic complications (SC) of surgery. Retrospective study including all CD patients who underwent surgery in our institution from January 2007 to June 2017. We considered early SC those taking place within 30 days of surgery. Patients were considered under the effect of immunosuppressive or immunomodulatory treatment if they were into treatment in the 4 weeks before surgery. Patients who had surgery for perianal lesions were excluded. A total of 72 patients with a mean age of 38.4 years old were enrolled (18–42). Ileal disease (55%) was more common than colonic or ileocolonic disease. Treatment was indicated for stricturing disease in 61% of patients and for penetrating disease in 39% of cases. Early SC developed in 19 patients (26%): 10 patients (52%) had wound infection, 2 had anastomotic leak, 2 developed intraabdominal abscess, 3 had enterocutaneous fistula and 2 presented bronchopulmonary infection. SC were significantly more frequent in patients operated for fistulising disease (p = 0.02). Wound infection and anastomotic leak were significantly more common in patients who were into steroids or biotherapies in the four weeks before surgery (p = 0.015). Serum Albumin levels were significantly lower in SC group (p = 0.04). In univariate and multivariate analysis, independent risk factors for post-operative SC were: fistulising disease (p = 0.02) and steroids intake within four weeks before surgery (0.012). Penetrating disease, steroids before surgery and low Serum Albumin levels are risk factors for SC after surgery for CD.