Glasgow prognostic score is a practical predictive index for postoperative intra-abdominal septic complications after bowel resection in Crohn’s disease patients

Abstract Aim Bowel resection in Crohn's disease still has a high rate of complications due to risk factors including immune suppression, malnutrition and active inflammation or infection at the time of operating. In this study, we use serological levels and inflammatory markers to predict the potential of complications in patients undergoing resections for complicated Crohn's disease. Methods All patients undergoing laparoscopic bowel resection for Crohn’s disease from 5th of November 2012 to 11th of October 2017 were included in this retrospective observational study. Patients were divided into 4 groups scoring 0, 1, 2 or 3 depending on their pre-operative haemoglobin concentration (Hb), C-reactive protein (CRP) and albumin (Alb) where 1 point was given for an abnormal value in each as detailed in the definitions. They were then grouped into a low risk group comprised of those scoring 0 and 1, and a high risk group for those scoring 2 and 3 and data was collected to compare outcomes and the incidence of septic complications. Results Seventy-nine patients were included. Eleven (13.9%) and 2 (2.5%) patients had 2 or 3 abnormal values of CRP, Alb and Hb and were categorized as high risk. High risk patients had a significantly higher rate of post-operative septic complications (30.7%) compared with low risk patients (10.6%) p value < 0.0001. Conclusion Pre-operative CRP, haemoglobin and albumin can serve as predictors of septic complications after surgery for Crohn’s disease and can therefore be used to guide pre-operative optimisation and clinical decision-making.

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Mo1815 – Modified Glasgow Prognostic Score is Useful for Predicting Long-Term Continuation of Anti-TNF Therapy in Patients with Crohn’s Disease

Gastroenterology ◽

10.1016/s0016-5085(19)39082-1 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-848

Author(s):

Takahiro Amano ◽

Shinichiro Shinzaki ◽

Yuriko Otake ◽

Mizuki Tani ◽

Takeo Yoshihara ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Modified Glasgow Prognostic Score

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Risk Factors for Postoperative Intra-abdominal Septic Complications after Bowel Resection in Patients with Crohn’s Disease

Diseases of the Colon & Rectum ◽

10.1097/dcr.0b013e3182617716 ◽

2012 ◽

Vol 55 (9) ◽

pp. 957-962 ◽

Cited By ~ 58

Author(s):

Amane Kanazawa ◽

Tetsuo Yamana ◽

Kinya Okamoto ◽

Rikisaburo Sahara

Keyword(s):

Risk Factors ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Resection ◽

Septic Complications

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A Practical Predictive Index for Intra-abdominal Septic Complications After Primary Anastomosis for Crohn’s Disease

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000000414 ◽

2015 ◽

Vol 58 (8) ◽

pp. 775-781 ◽

Cited By ~ 26

Author(s):

Lugen Zuo ◽

Yi Li ◽

Honggang Wang ◽

Weiming Zhu ◽

Wei Zhang ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Primary Anastomosis ◽

Predictive Index ◽

Septic Complications

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Efficacy of adalimumab in patients with Crohn's disease and symptomatic small bowel stricture: a multicentre, prospective, observational cohort (CREOLE) study

Gut ◽

10.1136/gutjnl-2016-312581 ◽

2017 ◽

Vol 67 (1) ◽

pp. 53-60 ◽

Cited By ~ 82

Author(s):

Yoram Bouhnik ◽

Franck Carbonnel ◽

David Laharie ◽

Carmen Stefanescu ◽

Xavier Hébuterne ◽

...

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Bowel Resection ◽

Prognostic Score ◽

Small Bowel Stricture ◽

Observational Cohort ◽

Prognosis Group ◽

Bowel Stricture

ObjectiveThe efficacy of anti-tumour necrosis factors (anti-TNFs) in patients with Crohn's disease (CD) and symptomatic small bowel stricture (SSBS) is controversial. The aim of this study was to estimate the efficacy of adalimumab in these patients and to identify the factors predicting success.DesignWe performed a multicentre, prospective, observational cohort study in patients with CD and SSBS. The included patients underwent magnetic resonance enterography at baseline and subsequently received adalimumab. The primary endpoint was success at week 24, defined as adalimumab continuation without prohibited treatment (corticosteroids after the eight week following inclusion, other anti-TNFs), endoscopic dilation or bowel resection. The baseline factors independently associated with success were identified using a logistic regression model, leading to a simple prognostic score. Secondary endpoints were prolonged success after week 24 (still on adalimumab, without dilation nor surgery) and time to bowel resection in the whole cohort.ResultsFrom January 2010 to December 2011, 105 patients were screened and 97 were included. At week 24, 62/97 (64%) patients had achieved success. The prognostic score defined a good prognosis group with 43/49 successes, an intermediate prognosis group with 17/28 successes and a poor prognosis group with 1/16 successes. After a median follow-up time of 3.8 years, 45.7%±6.6% (proportion±SE) of patients who were in success at week 24 (ie, 29% of the whole cohort) were still in prolonged success at 4 years. Among the whole cohort, 50.7%±5.3% of patients did not undergo bowel resection 4 years after inclusion.ConclusionsA successful response to adalimumab was observed in about two-thirds of CD patients with SSBS and was prolonged in nearly half of them till the end of follow-up. More than half of the patients were free of surgery 4 years after treatment initiation.Clinical Trial registration numberNCT01183403; Results.

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