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Inflammatory Bowel Disease Adversely Impacts Colorectal Cancer Surgery Short-term Outcomes and Health-Care Resource
Mitchell Ramsey1, Somashekar G Krishna2, Peter P Stanich2
1Department of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, USA.
Clinical and Translational Gastroenterology
|December 1, 2017
Summary
Patients with inflammatory bowel disease (IBD) undergoing colorectal cancer (CRC) surgery experience worse hospital outcomes. This includes longer stays, more complications, and higher readmission rates compared to non-IBD patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Public Health
Background:
- Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is a known risk factor for colorectal cancer (CRC).
- Limited population-based data exists on the inpatient surgical outcomes for CRC in patients with IBD.
Purpose of the Study:
- To compare inpatient hospital outcomes of colorectal cancer (CRC) surgery between patients with and without inflammatory bowel disease (IBD).
Main Methods:
- Utilized the National Inpatient Sample (2008-2012) and Nationwide Readmissions Database (NRD, 2013).
- Included adult patients (age ≥18 years) who underwent CRC surgery, comparing those with UC or CD to those without IBD.
- Performed multivariate analysis for in-patient outcomes, including postoperative complications, healthcare resource utilization, readmission rates, and mortality.
Main Results:
- Out of 397,847 CRC surgeries, 0.8% (3,242) involved patients with IBD.
- IBD patients had a longer length of stay (0.86 days longer).
- IBD patients experienced higher rates of postoperative complications (OR 1.26), including infections (OR 1.69) and deep vein thrombosis (OR 2.42), and required more blood transfusions (OR 1.59).
- CRC patients with IBD had a higher 30-day readmission rate (OR 1.44).
Conclusions:
- At a population level, inflammatory bowel disease (IBD) is associated with adverse inpatient surgical outcomes for colorectal cancer (CRC).
- These findings highlight the need for specialized perioperative care for IBD patients undergoing CRC surgery.
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