Postoperative outcomes in ustekinumab-treated patients undergoing abdominal operations for Crohn's disease: Single-center series

Amy L. Lightner, Fabian Grass, Ahmad Alsughayer, Molly M. Petersen, Laura E. Raffals, Edward V. Loftus

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: The impact of ustekinumab on adverse postoperative outcomes in Crohn's disease (CD) remains largely unknown. We determined the difference in 90-day postoperative complication rates among CD patients exposed to ustekinumab within 12 weeks prior to an abdominal operation as compared to patients not exposed to biologic therapy. Methods: A retrospective chart review of all adults with CD who underwent an abdominal operation between October 1, 2017 and December 31, 2018 at a single tertiary medical center was performed. Data collection included patient demographics, concurrent immunosuppression, serum laboratory values, operative values, and 90-day outcomes including superficial surgical site infection (sSSI), intra-abdominal sepsis, overall infectious complications, readmission, and reoperation rates. The primary outcome was the 90-day rate of intra-abdominal sepsis. Results: Fifty-seven CD patients received ustekinumab and 277 received no biologic therapy in the 12 weeks prior to major abdominal surgery. Ustekinumab-exposed patients were younger, less likely to have diabetes mellitus or active tobacco exposure, were more often obese, and more often taking a concurrent immunomodulator. Ustekinumab remained an independent predictor of intra-abdominal sepsis on multivariable logistic regression. Immunomodulator exposure was associated with significantly increased rates of sSSI and overall complication rates. Conclusions: Ustekinumab is associated with increased rates of 90-day postoperative intra-abdominal sepsis following a major abdominal operation for CD.

Original languageEnglish (US)
JournalCrohn's and Colitis 360
Volume1
Issue number2
DOIs
StatePublished - Jul 1 2019

Keywords

  • Crohn's disease
  • Postoperative outcomes
  • Ustekinumab

ASJC Scopus subject areas

  • Gastroenterology

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