DOP045 Post-operative complications in elderly-onset inflammatory bowel disease: a population-based study
Bibliographic record
Abstract
Background: Inflammatory Bowel Diseases (IBD) diagnosed after the age of 60 are increasing. Surgical rates are similar to those in the younger population. Post-operative complications (POC) in elderly-onset IBD have never been investigated at the population level. We reported the incidence and factors associated with POC in a well-defined population-based registry. Methods: Among 841 elderly-onset IBD patients from the EPIMAD registry (1), 139 (16.5%) patients underwent surgery: 100 had Crohn's Diseases (CD) and 39 ulcerative colitis (UC). Medical charts for early (≤30 days of surgery) and late (>30 days of surgery) POC were reviewed using the Dindo's classification (2). Associated factors were analyzed by logistic regression for early POC and Cox regression models for late POC. Results: After a median follow-up of 7.3 years [Q1=3-Q3=12], 50 patients (50/139, 36.0%) had at least one POC (n=69), without significant difference between UC and CD. Thirty-two early POC were observed in 23 of 50 patients; 48% of POC (15/32) were infectious and 52% of patients (12/23) had severe POC (defined by a Dindo's grade >2). Six (6/23, 26%) patients died because of early POC. Among the 37 late complications observed in 33 patients, 56% of POC (20/37) were mechanical (bridle, eventration, anastomotic stricture) and 42% of patients (15/33) had severe POC. The cumulative probability of late POC was 10.9% at 1 year (6.5–18.1), 22.8% at 5 years (16.0–32.0) and 30.5% (21.8–41.4) at 10 years. In multivariate analysis, emergency surgery (HR=4.46 [1.75–11.36]) and acute severe ulcerative colitis (HR=7.84 [2.15–28.52]) were significantly associated with early POC. Female gender (HR=2.10 [1.01–4.37]) and time between diagnosis and surgery >3 months (HR=2.09 [1.01–4.31]) were significantly associated with late POC. Conclusions: In elderly-onset IBD patients who underwent surgery, POC were frequent and half of them were severe. Emergency surgery and acute severe ulcerative colitis were significantly associated with early complications, while female gender and delay between diagnosis and surgery were associated with late POC. These results reinforce the need for specialized and dedicated management of elderly patients undergoing surgery. References: [1] Charpentier et al. Gut 2014 [2] Dindo et al. Ann. Surg. 2004
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".