{A figure is presented}A Prospective Multivariate Analysis of Clinical Factors Associated With Pouchitis After Ileal Pouch-Anal Anastomosis

Phillip Fleshner, Andrew Ippoliti, Marla Dubinsky, Steven Ognibene, Eric Vasiliauskas, Marjorie Chelly, Ling Mei, Konstantinos A. Papadakis, Carol Landers, Stephan Targan

Research output: Contribution to journalArticlepeer-review

79 Scopus citations

Abstract

Background & Aims: Although acute pouchitis (AP) after ileal pouch-anal anastomosis (IPAA) for UC is common and easily treated, chronic pouchitis (CP) remains a difficult management issue. The aim of this study was to identify important clinical risk factors associated with AP or CP. Methods: AP and CP were prospectively assessed, and demographic, disease, and treatment characteristics were tabulated. Univariate and multivariate analyses were performed to evaluate associations between AP or CP and potential risk factors. Results: Two hundred IPAA patients were followed for a median of 24 months (range, 3-117 months). Thirty-six patients (18%) developed AP, and 23 patients (12%) developed CP. On univariate analysis, the use of steroids before colectomy and smoking were associated with the development of AP. CP was associated with male gender, smoking, length of follow-up, extraintestinal manifestations, backwash ileitis, and elevated (450×109/L) platelet count. On multivariate analysis, the following risk factors were found to be independently associated with AP: use of steroids before colectomy (odds ratio [OR], 3.7; 95% confidence interval [CI], 1.5-8.9; P = .004) and smoking (OR, 2.3; 95% CI, 1.1-5.3; P = .04). CP was directly associated with extraintestinal manifestations (OR, 3.5; 95% CI, 1.1-11.1; P = .03), elevated platelet count (OR, 3.1; 95% CI, 1.1-8.9; P = .03), and increased length of follow-up (OR, 1.3; 95% CI, 1.1-1.6; P = .002). Smoking reduced the incidence of CP (OR, 0.2; 95% CI, 0.05-0.74; P = .04). Conclusions: Clinical factors associated with AP included use of steroids before colectomy and smoking. Factors directly related to CP were extraintestinal manifestations, elevated platelet count, and length of follow-up after IPAA. Smoking appears to protect against the development of CP.

Original languageEnglish (US)
Pages (from-to)952-958
Number of pages7
JournalClinical Gastroenterology and Hepatology
Volume5
Issue number8
DOIs
StatePublished - Aug 1 2007

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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