TOPLINE:

Among patients with inflammatory bowel disease (IBD), rates of malnutrition, infections requiring antibiotic treatment, and IBD-related hospitalizations were higher in the month before intestinal resection than in the 6-12 months before surgery, highlighting a preoperative decline that earlier surgical referral may help mitigate.

METHODOLOGY:

• About 10% of patients with ulcerative colitis and 26% of those with Crohn’s disease need surgical resection within 10 years of the initial diagnosis. Although early surgery improves clinical outcomes, little is known about changes in the year before surgery.
• In this multihospital retrospective study, researchers evaluated adults with IBD who underwent their first IBD-related intestinal resection between January 2018 and May 2023.
• Outcomes included malnutrition status, infection or abscess requiring antibiotics, venous thromboembolism (VTE), and any IBD-related hospitalization, among others.
• Clinical data were assessed 6-12 months before surgery and 1 month before surgery; changes in muscle mass were also evaluated using CT scans in the year prior to surgery.

TAKEAWAY:

• Researchers included 170 patients (median age at surgery, 32.6 years; 51% women), with a median disease duration of 7.4 years between IBD diagnosis and resection.
• In the month before surgery, rates of malnutrition (30% vs 18%), antibiotic-treated infections (74% vs 28%), and C-reactive protein levels (15.0 vs 5.0) were significantly higher than at 6-12 months before surgery (P < .01 for all).
• IBD-related hospitalizations increased more than sixfold, from 5% at 6-12 months to 31% in the month before surgery (P < .01).
• Although not significant, muscle mass declined in patients with two CT scans in the prior year, and VTE events rose in the month before surgery.
• Results were consistent across disease durations, age groups, and IBD subtypes.

IN PRACTICE:

“These results support earlier discussions among individuals who may eventually require surgery (eg, those with severe or refractory disease), as this may reduce the risk of developing such conditions, thereby lowering the risk of an adverse postoperative outcome,” the authors of the study wrote.

SOURCE:

This study was led by Vasantham Chaudhary, New York University Langone Health, New York City. It was published online in Therapeutic Advances in Gastroenterology.

LIMITATIONS:

Only 35 of the 170 participants were aged 50 years or older, limiting the power of subgroup analyses. The researchers relied on clinical notes and diagnostic codes rather than standardized assessments for conditions like malnutrition. The cohort was predominantly White (72%), limiting generalizability.

DISCLOSURES:

This study received support from multiple sources, including from The Leona M. and Harry B. Helmsley Charitable Trust, the National Institutes of Health, and the Crohn’s and Colitis Foundation, among others. Several authors reported receiving honoraria, research support, travel support, advisory board fees, and consultancy fees from multiple pharmaceutical and healthcare organizations.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.