INTRODUCTION: Additional ileocolonic resection(s) (ICR) in Crohn’s Disease (CD) patients undergoing the first ICR represents an important source of morbidity and complications. The factors that predict time to recurrent ICR are not well defined. Here we reviewed patients with stricturing CD who have had at least two ICRs to inquire if any clinical factors are associated with a short period of time between ICRs. METHODS: A cohort was designed using surgical billing codes for patients with CD who had an ICR between 2007 and 2018 at one institution and validated by manual chart review. Independent variables included age, sex, race, smoking, family history of IBD, duration of disease, Montreal phenotype, perianal involvement, biologic medications, total number of resections, and indication for surgery. The variables were tested independently for association with time between the first and second ICR (T1-2) using a multivariate linear regression model. Rutgeerts score between first and second ICR was tested using one-way ANOVA (using i0 and >=i1, compared to T1-2) for the 29 patients with endoscopic data. RESULTS: From the initial cohort of 365 patients, 294 patients were excluded due to surgical indication other than stricture, location not ileocecum, only one ICR, extreme outlier results (n = 2) and incomplete charts. Demographic data is shown in Table 1. A total of 14 patients used biologic medications prior to index ICR, and an additional 42 patients were started on biologics between first and second ICR. Taking biologics before the first resection was associated with a shorter T1-2 (5.2 vs 10.8 years, P = 0.0009). Starting biologics after index surgery did not impact T1-2. The remainder of the variables tested did not show a significant association with T1-2. The average amount of time for T1-2 was 9.5 years. CONCLUSION: In patients who underwent recurrent ICR, being prescribed biologics before index resection is significantly associated with a shorter time from index to subsequent resection (P < 0.001). However, this variable only explains 12% of the variability, suggesting additional variables affect T1-2. This association may be explained by a confounding factor such as disease activity/more aggressive CD phenotype. It is also possible that in a substrata of CD patients, taking biologics before index ICR accelerates pro-fibrogenic mechanisms. Future studies are needed to identify more clinical and/or molecular factors that would further explain and predict need for subsequent ICRs in CD patients.Table 1.: Demographics