Effect of perioperative immunosuppressive medication on early outcome in Crohn's disease patients

Adrian A. Indar, Tonia M. Young-Fadok, Jacques Heppell, Jonathan E. Efron

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Abstract

Background: The aim of the present study was to examine the early outcome in patients undergoing intestinal resection for Crohn's disease (CD) while they are receiving perioperative immunosuppressive medication. Methods: We reviewed patients with CD undergoing intestinal surgery from 1999 to 2007. Demographics and relevant perioperative information, including medication, were extracted from patient charts. Statistical analysis was performed using Fisher's exact test. Results: During the course of the study period 112 with Crohn's disease underwent intestinal resection, and 69 of them were receiving perioperative medication (47, corticosteroids; 39, immunomodulators; and 17, anti-tumor necrosis factor-α antibodies). There were no deaths. Median blood loss was 137 ml. Twenty-two of the patients using perioperative medication (32%) experienced complications, 10 of which were major. The major complications occurred in 3 of the 43 patients (7%) who were not receiving perioperative medications, in 5 of 38 patients (13%) who were receiving one drug, 4 of 28 patients (14%) receiving two drugs, and 1 of 3 patients (33%) receiving three drugs. Thus the occurrence of major complications was not significantly greater in patients receiving perioperative medication. Risk factors for a major complication were intraoperative blood loss >400 ml (P < 0.003) and emergency surgery (P < 0.005). Conclusions: The occurrence of complications in Crohn's disease patients undergoing intestinal resection was not associated with the use of immunosuppressive medication. However, emergency surgery and blood loss were risk factors, and reflect the difficulty of surgery in this group of patients.

Original languageEnglish (US)
Pages (from-to)1049-1052
Number of pages4
JournalWorld Journal of Surgery
Volume33
Issue number5
DOIs
StatePublished - May 2009

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Immunosuppressive Agents
Crohn Disease
Emergencies
Pharmaceutical Preparations
Intraoperative Complications
Immunologic Factors
Adrenal Cortex Hormones
Tumor Necrosis Factor-alpha
Demography
Antibodies

ASJC Scopus subject areas

  • Surgery

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Effect of perioperative immunosuppressive medication on early outcome in Crohn's disease patients. / Indar, Adrian A.; Young-Fadok, Tonia M.; Heppell, Jacques; Efron, Jonathan E.

In: World Journal of Surgery, Vol. 33, No. 5, 05.2009, p. 1049-1052.

Research output: Contribution to journalArticle

Indar, Adrian A. ; Young-Fadok, Tonia M. ; Heppell, Jacques ; Efron, Jonathan E. / Effect of perioperative immunosuppressive medication on early outcome in Crohn's disease patients. In: World Journal of Surgery. 2009 ; Vol. 33, No. 5. pp. 1049-1052.
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