Risk of Postoperative Infection in Patients with Inflammatory Bowel Disease.
- Author:
Hyo Suk AHN
1
;
Sang Kil LEE
;
Hyo Jong KIM
;
Jae Young JANG
;
Kwang Ro JOO
;
Seok Ho DONG
;
Byung Ho KIM
;
Joung Il LEE
;
Young Woon CHANG
;
Rin CHANG
Author Information
1. Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea. hjkim@khmc.or.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Inflammatory bowel diseases;
Postoperative infection
- MeSH:
Colitis, Ulcerative/drug therapy/*surgery;
Crohn Disease/drug therapy/*surgery;
Humans;
Immunologic Factors/*adverse effects/therapeutic use;
Immunosuppressive Agents/*adverse effects/therapeutic use;
Infection/epidemiology/*etiology;
Postoperative Complications/epidemiology/*etiology;
Retrospective Studies
- From:The Korean Journal of Gastroenterology
2006;48(5):306-312
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The clinical course of patients with inflammatory bowel disease (IBD) frequently leads to the use of immunosuppressants and immunomodulators. We investigated the risk of postoperative infection in patients with IBD undergoing elective bowel surgery and whether the use of corticosteroid (CS) and/or 6-mercaptopurine/ azathioprine (6-MP/AZA) before surgery was associated with the increased risk of postoperative infection. METHODS: Patients who were diagnosed as Crohn's disease (n=25) or ulcerative colitis (n=19) and underwent elective bowel surgery between 1986 and 2005 were identified. Medical records were retrospectively analyzed including age, sex, duration of disease, indication for surgery, duration of surgery, type of surgery, type of postoperative infection, admission period, usage of CS and 6-MP/AZA, and preoperative laboratory values. There were 27 patients receiving CS alone, 6 patients receiving 6-MP/AZA alone or with CS, and 16 patients receiving neither CS nor 6-MP/AZA. RESULTS: There were 17 postoperative infections (38.6%) among IBD patients who had undergone surgery and wound infection was the most common type of infection (76.5%). In IBD patients, patients receiving CS had higher postoperative infection rate than those patients receiving neither CS nor 6-MP/AZA (p=0.039). Patients receiving CS in conjunction with 6-MP/AZA did not have significantly higher postoperative infection rate than those with CS only (p=0.415). CONCLUSIONS: Preoperative use of CS in patients with IBD is associated with the increased risk of postoperative infections. Addition of 6-MP/AZA in patients receiving CS does not increase the risk of postoperative infections.
