P367 Vedolizumab and early postoperative complications in non-intestinal surgery: A case-matched analysis
Bibliographic record
Abstract
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.
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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 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".