title: The effect of immune therapy on surgical site infection following Crohn's Disease resection.
abstract: BACKGROUND
  Patients with Crohn's disease are increasingly receiving antitumour necrosis factor α (anti-TNF-α) therapy. Whether anti-TNF-α therapy increases the risk of postoperative infectious complications in Crohn's disease is a matter of debate.
  
  
  METHODS
  This was a retrospective study of three referral centres. The charts of patients who underwent ileocaecal or ileocolonic resection for Crohn's disease between 2000 and 2011 were reviewed. The impact of baseline characteristics and Crohn's disease-related medications on the risk of postoperative intra-abdominal infectious complications was investigated by univariable and multivariable analysis.
  
  
  RESULTS
  A total of 217 patients were included in the study. Median age at the time of surgery was 36·8 (range 15-78) years. A postoperative intra-abdominal infection occurred in 24 (11·1 per cent) of 217 patients. No deaths were reported. On univariable analysis, age less than 25 years (P = 0·023), steroid use (P = 0·017), anti-TNF-α therapy (P = 0·043) and anti-TNF-α treatment in combination with steroids (P = 0·004) were associated with an increased risk of postoperative intra-abdominal infectious complications. On multivariable analysis, only anti-TNF-α therapy in combination with steroids significantly increased this risk (odds ratio 8·03, 95 per cent confidence interval 1·93 to 33·43; P = 0·035).
  
  
  CONCLUSIONS
  Combined use of steroids and anti-TNF-α therapy was associated with an increased risk of postoperative intra-abdominal infectious complications.
authors: Department of Digestive Surgery, University Hospital of Nancy-Brabois, Nancy, France. t.serradori@chu-nancy.fr
authors: T
authors: T
authors: Serradori
authors: A
authors: A
authors: Germain
authors: M L
authors: ML
authors: Scherrer
authors: C
authors: C
authors: Ayav
authors: M
authors: M
authors: Perez
authors: B
authors: B
authors: Romain
authors: J P
authors: JP
authors: Palot
authors: S
authors: S
authors: Rohr
authors: L
authors: L
authors: Peyrin-Biroulet
authors: L
authors: L
authors: Bresler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology; D001685:Biological Factors / Q000009:adverse effects; D003424:Crohn Disease / Q000188:drug therapy / Q000601:surgery*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects* / Q000379:methods; D059413:Intraabdominal Infections / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013256:Steroids / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D001685:Biological Factors; D004338:Drug Combinations; D013256:Steroids; D014409:Tumor Necrosis Factor-alpha