Post‐operative complications in elderly onset inflammatory bowel disease: a population‐based study

Abstract

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.

Crohn’s disease and ulcerative colitis are associated with different lipid profile disorders: a nationwide population‐based study

“…Therefore, individuals with persistently low lipid profiles at medical check‐up may be prioritised as high risk patients for IBD, and be educated to pay early visit to clinic with certain symptoms, including abdominal pain, diarrhoea, hematochezia or chronic weight loss. As elderly IBD patients, especially those above age 60 are at high risk for post‐operative complication, morbidity and mortality, we believe that our study would benefit in the detection and management of these patients through early intervention and disease course modification. Third, due to the observational and retrospective nature of the study, the pathophysiology of each lipid profile affecting the incidence of IBD, as well as mechanism for the effect of statin on the incidence of IBD, could not be evaluated.…”

Editorial: post‐operative complications in elderly onset inflammatory bowel disease—what is surgery, what is disease, and what is delay of surgery?

“…An English study on emergency colorectal surgery found the 30‐day mortality risk to be four‐times greater compared with scheduled procedures . Similar to Sacleux et al , they found UC to be associated with more complications than CD. The overall 30‐day mortality risk after subtotal colectomy due to UC was 4.7% in England, and 23% in patients ≥70 years old .…”

“…Late onset disease has been described as mild but surgical rates are actually higher (13%) compared with adult and paediatric patients (10% and 9%, respectively) after five years . The French EPIMAD Group have now reported on the outcomes after surgical intervention in 139 incident patients with late onset IBD (≥60 years) 1988‐2006 . Complications within 30 days were quite common, 14% in Crohn's disease (CD) and 23% in ulcerative colitis (UC).…”

“…Sacleux et al describe a number of long‐term adverse effects, of which mechanical complications and decompensation of other chronic diseases are the two most common. Although these late adverse effects could be due to surgery, some could rather be related to disease progression (eg new strictures in CD).…”

Editorial: post‐operative complications in elderly onset inflammatory bowel disease—what is surgery, what is disease, and what is delay of surgery? Authors’ reply

“…We took the opportunity to study the natural history of IBD in the elderly onset group within this cohort and to provide safety data on surgical options. We showed that surgery, especially in the emergency setting and in the context of severe ulcerative colitis (UC) attacks, was associated with early post‐operative complications – especially infections . Some of these complications may be easily prevented and being prepared for potential risks is usually the first step to handle them properly.…”