Impact of biological agents on postsurgical complications in inflammatory bowel disease: A multicentre study of Geteccu

García, M. J. ; Rivero, M. ; Miranda-Bautista, J. ; Bastón-Rey, I. ; Mesonero, F. ; Leo-Carnerero, E. ; Casas-Deza, D. ; Cagigas Fernández, C. ; Martin-Cardona, A. ; El Hajra, I. ; Hernández-Aretxabaleta, N. ; Pérez-Martínez, I. ; Fuentes-Valenzuela, E. ; Jiménez, N. ; Rubin de Célix, C. ; Gutiérrez, A. ; Suárez Ferrer, C. ; Huguet, J. M. ; Fernández-Clotet, A. ; González-Vivó, M. ; Del Val, B. ; Castro-Poceiro, J. ; Melcarne, L. ; Dueñas, C. ; Izquierdo, M. ; Monfort, D. ; Bouhmidi, A. ; Ramírez de la Piscina, P. ; Romero, E. ; Molina, G. ; Zorrilla, J. ; Calvino-Suárez, C. ; Sánchez, E. ; Núñez, A. ; Sierra, O. ; Castro, B. ; Zabana, Y. ; González-Partida, I. ; De la Maza, S. ; Castaño, A. ; Nájera-Muñoz, R. ; Sánchez-Guillén, L. ; Riat Castro, M. ; Rueda, J. L. ; Benítez, J. M. ; Delgado-Guillena, P. ; Tardillo, C. ; Peña, E. ; Frago-Larramona, S. ; Rodríguez-Grau. M. C. ; Plaza, R. ; Pérez-Galindo, P. ; Martínez-Cadilla, J. ; Menchén, L. ; Barreiro-De Acosta, M. ; Sánchez-Aldehuelo, R. ; De la Cruz, M. D. ; Lamuela, L. J. ; Marín, I. ; Nieto-García, L. ; López San Román, A. ; Herrera, J. M. ; Chaparro, M. ; Gisbert, J. P. ; Young Group of GETECCU

Resumen: Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections.

Idioma: Inglés

DOI: 10.3390/jcm10194402

Año: 2021

Publicado en: Journal of Clinical Medicine 10, 19 (2021), 4402 [17 pp.]
ISSN: 2077-0383

Factor impacto JCR: 4.964 (2021)

Categ. JCR: MEDICINE, GENERAL & INTERNAL rank: 55 / 172 = 0.32 (2021) - Q2 - T1

Factor impacto CITESCORE: 4.4 - Medicine (Q2)

Factor impacto SCIMAGO: 1.04 - Medicine (miscellaneous) (Q1)

Tipo y forma: Artículo (Versión definitiva)