Is Modern Medical Management Changing Ultimate Patient Outcomes in Inflammatory Bowel Disease?

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Inflammatory Bowel Disease (IBD) Epidemiology

Background:

• The effect of modern medical treatments on inflammatory bowel disease (IBD) surgery is not well understood.
• Biologic therapies may lead to operating on sicker patients, potentially impacting surgical necessity and outcomes.

Purpose of the Study:

• To investigate trends in IBD surgery rates and postoperative outcomes.
• To assess the impact of biologic medications on surgical necessity and patient health.

Main Methods:

• Utilized the Nationwide Inpatient Sample and ICD-9-CM codes for Crohn's disease and ulcerative colitis admissions.
• Analyzed trends in IBD nutrition, surgical interventions, and postoperative complications.

Main Results:

• IBD surgery rates remained stable (9-12%) for both Crohn's disease and ulcerative colitis.
• Poor nutrition rates increased significantly (67% in ulcerative colitis, 83% in Crohn's disease).
• Postoperative infection rates decreased in Crohn's disease but showed no trend in ulcerative colitis; anastomotic leak rates were unchanged.

Conclusions:

• IBD surgery rates have been stable, with stable or decreased postoperative infectious complications post-biologic therapy.
• An increase in poor nutrition among surgical IBD patients was observed.