[Risk of postoperative infection in patients with inflammatory bowel disease].
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.
Ahn
Hyo Suk
HS
Department of Internal Medicine, Kyung Hee University College of Medicine, Dongdaemun-Gu, Seoul, Korea.
Lee
Sang Kil
SK
Kim
Hyo Jong
HJ
Jang
Jae Young
JY
Joo
Kwang Ro
KR
Dong
Seok Ho
SH
Kim
Byung Ho
BH
Lee
Joung Il
JI
Chang
Young Woon
YW
Chang
Rin
R
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
D007155:Immunologic Factors; D007166:Immunosuppressive Agents