Contributors: Registre EPIMAD; CHU Rouen; Normandie Université (NU)-Normandie Université (NU)-CHU Amiens-Picardie-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille); Normandie Université (NU); Lille Inflammation Research International Center - U 995 (LIRIC); Institut Pasteur de Lille; Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille); Service d'Epidémiologie et de Santé Publique [Lille]; Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille); Maison Régionale de la Recherche Clinique [Lille]; CHU Amiens-Picardie; Hôpital privé Arras les Bonnettes; Hôpital Claude Huriez [Lille]; CHU Lille; Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy); This work is issued from the Epimad Registry. EPIMAD is supported by the Institut National de la Santé et de la Recherche Médicale (INSERM) and the Agence, Santé Publique, France and also received financial support from the François Aupetit Association. This study was funded in part by a grant from the Prgogramme Hospitalier de Recherche Clinique 2010.; The authors wish to thank the interviewing practitioners who collected the data: N. Guillon, I. Rousseau, A. Pétillon, B. Turck, P. Fosse, S. Auzou, M. Leconte, C. Le Gallo and D. Rime. The authors thank all adult and paediatric gastroenterologists who participated in this study. We also thank for its logistic help the European DigestScience Charity Foundation.
نبذة مختصرة : Comment in :Editorial: post-operative complications in elderly onset inflammatory bowel disease-what is surgery, what is disease, and what is delay of surgery? [Aliment Pharmacol Ther. 2018]Editorial: post-operative complications in elderly onset inflammatory bowel disease-what is surgery, what is disease, and what is delay of surgery? Authors' reply. [Aliment Pharmacol Ther. 2018]; International audience; BACKGROUND: IBD diagnosed after the age of 60 is increasing. Data on post-operative complications in elderly onset IBD are scarce.AIM: To describe the incidence of and factors associated with post-operative complications in elderly onset IBD, diagnosed after the age of 60.METHODS: Using EPIMAD Cohort (1988-2006), among 841 incident IBD patients, 139 (17%) underwent intestinal surgery, including 100 Crohn's disease (CD) and 39 ulcerative colitis (UC).RESULTS: After a median post-operative follow-up of 6 years (2-10), 50 (36%) patients experienced at least 1 complication with a total of 69. During the first 30 post-operative days, the mortality rate was 4%. Thirty-two early complications (grade 2) without significant difference between CD and UC (P = 0.28). Thirty-seven long-term adverse effects of surgical therapy (≥30 days) were observed in 33 patients (24%). Multivariate analysis found (1) acute severe colitis (OR = 7.84 [2.15-28.52]) and emergency surgery (OR = 4.46 [1.75-11.36]) were associated with early post-operative complications, and (2) Female gender (HR = 2.10 [1.01-4.37]) and delay before surgery >3 months (HR = 2.09 [1.01-4.31]) with long-term adverse effects of surgical therapy.CONCLUSIONS: One-third of elderly IBD patients experienced at least 1 post-operative complication. Half of the early complications were severe, and infectious. Emergency surgery was the key driver for post-operative complication.
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