Anti-TNF therapy is not associated with an increased risk of post-colectomy complications, a population-based study
| Autor: | S. Radley, Stephen T. Ward, Jamie-Rae Tanner, Jemma Mytton, L. Henderson, Felicity Evison, V. Amin |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Population Logistic regression Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Gastrointestinal Agents Risk Factors Humans Medicine education Colectomy Aged education.field_of_study Tumor Necrosis Factor-alpha business.industry Incidence (epidemiology) Gastroenterology Middle Aged medicine.disease Ulcerative colitis Infliximab Surgery Increased risk Case-Control Studies 030220 oncology & carcinogenesis Colitis Ulcerative Female 030211 gastroenterology & hepatology Anti-TNF therapy business medicine.drug |
| Zdroj: | Colorectal Disease. 20:416-423 |
| ISSN: | 1462-8910 |
| DOI: | 10.1111/codi.13937 |
| Popis: | AIM Previous studies have raised concerns that the use of anti-tumour necrosis factor (anti-TNF) therapy in patients with ulcerative colitis (UC) undergoing surgery may increase the risk of postoperative complications. We have taken a population-based approach to investigate whether there is an association between anti-TNF therapy and postoperative complications in UC patients undergoing subtotal colectomy. METHOD Hospital Episode Statistics (HES) data and procedural coding were used to identify all patients in England between April 2006 and March 2015 undergoing subtotal colectomy for UC. Patients were grouped into those who received anti-TNF therapy within 12 or 4 weeks of surgery and those who did not. The incidence of postoperative complications was evaluated by HES coding and compared between groups. RESULTS In all, 6225 UC patients underwent subtotal colectomy. 753 patients received anti-TNF therapy within 12 weeks prior to surgery (418 within 4 weeks). There was no difference in postoperative complications between groups although groups were not comparable for age and comorbidities. Logistic regression with complications as the outcome variable did not show any significant association between anti-TNF therapy and complications. Colectomy performed during an unplanned admission (vs planned admission) and smoking were associated with complications. CONCLUSION This large population-based study does not demonstrate any association between preoperative anti-TNF therapy and postoperative complications in UC patients undergoing subtotal colectomy. The only variables associated with complications were colectomy performed during an unplanned admission and smoking. |
| Databáze: | OpenAIRE |
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