Faculty Collaboration Database

Surgical outcomes in the elderly with inflammatory bowel disease are similar to those in the younger population. Dig Dis Sci 2013 Oct;58(10):2955-62

Date

07/10/2013

Pubmed ID

23836319

DOI

10.1007/s10620-013-2754-2

Scopus ID

2-s2.0-84885301580 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

BACKGROUND: Inflammatory bowel disease (IBD) has a bimodal distribution with approximately 15 % of patients manifesting after age 65. Previous reports suggest an increased risk of surgical complications in the elderly.

AIM: To compare surgical outcomes in elderly IBD patients (≥ 65 years at the time of surgery) to matched younger IBD cohorts.

METHODS: This was a retrospective cohort study at a single academic center of patients who underwent surgery for IBD. Forty-two elderly patients (≥ 65 years) were matched at least 1:1 (median 1:5) to patients in each of three control groups [18-35 years (n = 71); 36-49 years (n = 62); 50-64 years (n = 58)] according to gender, disease type/location, and type of surgery. Postoperative complications were compared. Patient characteristics were used in multivariate risk models. Analysis was performed using ordinary logistic regression.

RESULTS: Twenty ileal or ileocolonic resections, 12 partial or total colectomies, four stricturoplasties, and six laparoscopic partial or total colectomies were performed in the elderly group. The post-operative complication rate was not statistically different between the elderly and younger cohorts (38 % vs. 39 % vs. 40 % vs. 48 % in the 18-35, 36-49, 50-64, and ≥ 65 years groups, respectively, p = 0.26). The only significant risk factors for complication were Charlson comorbidity index (p = 0.0002), preoperative hemoglobin (p = 0.0065), total parenteral nutrition use (p = 0.024), and failed medical therapy (as the indication for surgery) (p = <0.0001).

CONCLUSIONS: The surgical complication rate among elderly and younger IBD patients was similar. Advanced age by itself should not be considered a risk factor for adverse operative outcome.

Author List

Bautista MC, Otterson MF, Zadvornova Y, Naik AS, Stein DJ, Venu N, Perera LP

Authors

Mary F. Otterson MD Professor in the Surgery department at Medical College of Wisconsin
Daniel J. Stein MD Director, Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Factors
Cohort Studies
Colectomy
Female
Humans
Inflammatory Bowel Diseases
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Risk Factors
Treatment Outcome
Young Adult