Evidence map›Paper›PMID 35705188›Full record

ArticleJournal of Crohn's & colitis2022

Intra-abdominal septic complications after ileocolic resection increases risk for endoscopic and surgical postoperative Crohn's disease recurrence.

Salam P Bachour, Ravi S Shah, Florian Rieder, Taha Qazi, Jean Paul Achkar, Jessica Philpott, Bret Lashner, Stefan D Holubar, Amy L Lightner, Edward L Barnes and 4 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of Crohn's & colitis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 16 citations in OpenAlex.

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  10. Timing of individualized surgical intervention in Crohn's disease.World journal of gastrointestinal surgery · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Salam P BachourCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.ORCID 0000-0002-0226-7513
Ravi S ShahCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Florian RiederCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Taha QaziCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Jean Paul AchkarCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Jessica PhilpottCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Bret LashnerCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Stefan D HolubarCleveland Clinic Department of Colorectal Surgery, Cleveland, OH, USA.ORCID 0000-0002-2549-9042
Amy L LightnerCleveland Clinic Department of Colorectal Surgery, Cleveland, OH, USA.
Edward L BarnesUniversity of North Carolina at Chapel Hill, Division of Gastroenterology and Hepatology, Chapel Hill, NC, USA.ORCID 0000-0001-9894-8796
Jordan AxelradNew York University Department of Gastroenterology and Hepatology, New York, NY, USA.ORCID 0000-0003-1951-7790
Miguel RegueiroCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.ORCID 0000-0002-7681-8111
Benjamin ClickCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Benjamin L CohenCleveland Clinic Department of Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.
Cleveland Clinic · USCleveland Clinic Lerner College of Medicine · USNew York University · USUniversity of North Carolina at Chapel Hill · US

Funding

Creeping fat and Crohn's disease associated stricturesR01DK123233 · NIDDK · CLEVELAND CLINIC LERNER COM-CWRU · PI RIEDER, FLORIAN · 2020 to 2024
$1.9M
The Role of Enteric Infection in Flares of Inflammatory Bowel DiseaseK23DK124570 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI AXELRAD, JORDAN ERIC · 2021 to 2025
$998k
Cleveland Clinic Lerner Research Institute Research ProgramNIDDK NIH HHS K23 DK124570NIDDK NIH HHS R01 DK123233
6 · The paper itself

Abstract

backgroundPostoperative recurrence [POR] of Crohn's disease following ileocolonic resection is common. The impact of immediate postoperative intra-abdominal septic complications [IASC] on endoscopic and surgical recurrence has not been elucidated.

aimsTo evaluate if IASC is associated with an increased risk for endoscopic and surgical POR.

methodsThis was a retrospective study of adult Crohn's disease patients undergoing ileocolonic resection with primary anastomosis between 2009 and 2020. IASC was defined as anastomotic leak or intra-abdominal abscess within 90 days of the date of surgery. Multivariable logistic and Cox proportional hazard modelling were performed to assess the impact of IASC on endoscopic POR [modified Rutgeerts' score ≥ i2b] at index postoperative ileocolonoscopy and long-term surgical recurrence.

resultsIn 535 Crohn's disease patients [median age 35 years, 22.1% active smokers, 35.7% one or more prior resection] had an ileocolonic resection with primary anastomosis. A minority of patients [N = 47; 8.8%] developed postoperative IASC. In total, 422 [78.9%] patients had one or more postoperative ileocolonoscopies, of whom 163 [38.6%] developed endoscopic POR. After adjusting for other risk factors for postoperative recurrence, postoperative IASC was associated with significantly greater odds (adjusted odds ratio [aOR]: 2.45 [1.23-4.97]; p = 0.01) and decreased time (adjusted hazards ratio [aHR]: 1.60 [1.04-2.45]; p = 0.03] to endoscopic POR. Furthermore, IASC was associated with increased risk (aOR: 2.3 [1.04-4.87] p = 0.03) and decreased survival-free time [aHR: 2.53 [1.31-4.87]; p = 0.006] for surgical recurrence.

conclusionIASC is associated with an increased risk for endoscopic and surgical POR of Crohn's disease. Preoperative optimization to prevent IASC, in addition to postoperative biological prophylaxis, may help reduce the risk for endoscopic and surgical POR.

Indexed as

Crohn DiseaseAdultAnastomosis, SurgicalColonColonoscopyHumansIleumPostoperative ComplicationsRecurrenceRetrospective StudiesCrohn’s diseaseinfectionpostoperative complicationspostoperative recurrence

Identifiers

PMID35705188
PMCPMC9924045
OpenAlexW4282983364

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.