36b74d7fba1ae6646b18dc0e98094d1b pmc_34640421.pdf 305eacabd4583b3110207b7f5d5ba28b10a7fa1a pmc_34640421.pdf 5964d5f96f3e8bed23c1c1c109a3ea5e42847861b71ce19d75e1e44788e20520 pmc_34640421.pdf Title: Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu Subject: 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. Keywords: inflammatory bowel disease; Crohn’s disease; ulcerative colitis; anti-TNF; ustekinumab; vedolizumab; postoperative complications; surgery; preoperative therapy Author: Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Oct 12 08:17:32 2021 CEST ModDate: Tue Oct 12 08:20:37 2021 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 760640 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- WITNDW+VnURWPalladioL Type 1 Custom yes yes no 10 0 GALJDQ+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 PTREYK+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 VSSSNI+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 DGBDNV+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 UFKNXE+CMSY10 Type 1 Builtin yes yes no 87 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 97 0 HEAOJP+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 123 0 HEAOKA+PalatinoLinotype CID TrueType Identity-H yes yes yes 126 0 HEAOKB+PalatinoLinotype TrueType WinAnsi yes yes no 132 0 HEAOKD+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 135 0 CKBPVA+EURM10 Type 1 Builtin yes yes no 154 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:38:53 CEST RepresentationInformation: pmc_34640421.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:05:52 CEST Size: 760640 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 374 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design and Population Destination: subsection.2.1 Item: Title: Data Collection Destination: subsection.2.2 Item: Title: Definitions Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Patient Population Destination: subsection.3.1 Item: Title: Postoperative Complications Destination: subsection.3.2 Item: Title: Postoperative Complications According to Exposure Destination: subsection.3.3 Item: Title: Predictive Factors Associated with the Appearance of Postoperative Complications Destination: subsection.3.4 Item: Title: Type of Biological Therapy during the Preoperative Period and Its Impact onPostoperative Complications Destination: subsection.3.5 Item: Title: Sensitivity Analysis Destination: subsection.3.6 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu Author: Subject: 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. 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