P367 Vedolizumab and early postoperative complications in non-intestinal surgery: A case-matched analysis
Notice bibliographique
Résumé
Vedolizumab (VDZ) is a gut-specific alpha-4-β-7 integrin antagonist that has demonstrated efficacy in Crohn’s disease (CD) and ulcerative colitis (UC). The safety of VDZ in the perioperative period remains unclear, with previous reports of increased surgical site infection (SSI) rates after intestinal operations. The aim of this study was to evaluate postoperative complications and perioperative safety in VDZ-treated patients undergoing non-intestinal operations. A retrospective case-matched study was performed at 2 IBD international referral centres. Adult patients with CD and UC who underwent a non-intestinal surgical procedure during treatment with VDZ were included. Patients who had their last VDZ infusion up to 12 weeks before the procedure were considered exposed and were matched in a 1:1 ratio to patients without VDZ therapy, according to type of surgical procedure, age and gender. After electronic chart review, the overall early postoperative infectious complications (up to 30 days after surgery), readmissions, reoperations, presence of SSI, and other infections were subsequently compared between the 2 groups with Pearson chi square test and Wilcoxon rank-sum, with p < 0.05 considered significant. A total of 36 procedures were performed in 34 patients from the VDZ cohorts at both institutions (2 patients had 2 procedures each during VDZ therapy), and were matched with 36 controls. The median age (IQR) was 51 years (37–63) in the VDZ group and 55 years (38–66) in controls (p = 0.55), with 26 female patients (72%) in each group (p = 1.00). Smoking status was also similar between the groups (p = 0.36). Mean BMI (kg/m2) was 24.0 (21.3–28.3) and 31.4 (26.3–39.3) in VDZ and control groups, respectively (p = 0.0003). There were no differences in terms of postoperative complications between the groups for all variables analysed. Overall infectious complications were similar between VDZ and control groups (14% vs. 8% respectively, p = 0.45). The same pattern was observed in superficial surgical site infections (6% vs. 0%, p = 0.15), reoperations (6% vs. 3%, p = 0.56) and readmissions (11% vs. 6%, p = 0.37). Moreover, there was no differences observed in urinary tract (p = 0.56) or central line infections (p = 0.31). VDZ-treated IBD patients undergoing non-intestinal procedures did not have an increased risk of overall postoperative infections or other complications as compared with controls. These findings underscore the gut-selective properties of VDZ, which may offer an improved safety profile to alternative systemic biologic therapies in the perioperative period of non-intestinal surgery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».