title: [Risk of postoperative infection in patients with inflammatory bowel disease].
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Internal Medicine, Kyung Hee University College of Medicine, Dongdaemun-Gu, Seoul, Korea.
authors.forename: Hyo Suk
authors.initials: HS
authors.lastname: Ahn
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
authors.forename: Hyo Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Kwang Ro
authors.initials: KR
authors.lastname: Joo
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Dong
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Kim
authors.forename: Joung Il
authors.initials: JI
authors.lastname: Lee
authors.forename: Young Woon
authors.initials: YW
authors.lastname: Chang
authors.forename: Rin
authors.initials: R
authors.lastname: Chang
mesh_terms: D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000601:surgery*; D003424:Crohn Disease / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007239:Infections / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D007155:Immunologic Factors; D007166:Immunosuppressive Agents