A125 PERIOPERATIVE ANTI-TNFα AGENTS AND POST-OPERATIVE INFECTIOUS COMPLICATIONS IN ELECTIVE SURGICAL IBD PATIENTS
Bibliographic record
Abstract
Biologic agents are commonly interrupted prior to surgical intervention for inflammatory bowel disease (IBD) to avoid risk of infection. Previous reviews report increased rates of post-operative infections, however, these included patients undergoing emergent surgeries, which have an inherently higher complication risk. To conduct a systematic review and meta-analysis aims to quantify the risk of post-operative infection in IBD patients on biologic therapy undergoing elective surgery. EMBASE, Medline, Cochrane CENTRAL, clinialtrials.gov, and the International Clinical Trials Registry Platform were searched without language restriction. Studies comparing infection rates for IBD patients on and off biologic therapy undergoing elective (non-emergent) surgery were eligible. The primary outcome was any post-operative infection. Secondary outcomes included overall complications and rates of specific infections. Meta-analyses were performed using a random-effects models. Studies were weighted by the inverse variance method. Pooled risk ratios were calculated for infectious complications, overall complications, and specific infectious outcomes. Fourteen studies totaling 3544 patients were included. Six assessed Crohn’s disease (CD), five assessed ulcerative colitis (UC), and three assessed both. All studies examined outcomes after elective surgeries for IBD. Infliximab was the intervention in eight studies, adalimumab in one, and five assessed any anti-TNFa. Pooled estimates of infectious complication rates were 13.7% [95% CI 8.9, 20.6] and 16.7% [95% CI 9.4, 27.8] in the control and therapy groups respectively, [risk difference 0.08% [95% CI -10.8, 11.0, p=0.99]]. For total complications, the between group risk difference was 3.5% [95% CI -1.3, 8.3, p=0.15]. No significant difference was identified between control and therapy groups for anastomotic leak, surgical site infection, urinary tract infection, nosocomial pneumonia, or C. difficile infection. In the setting of elective surgery, no difference in the risk of post-operative infections or other complications was observed in IBD on biologic therapy at the time of surgery versus those who were not. Pooled analysis of studies reporting overall infectious complications. Absolute risk difference between groups is 0.08% [95% CI -10.8, 11.0, p=0.99]. RD - risk difference. Heterogeneity was moderate to high. None
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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 | 0.006 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.020 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| 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".