Postoperative Complications in Crohnʼs Disease and Ulcerative Colitis Patients - A Province-Wide Cohort Study Presidential Poster
Bibliographic record
Abstract
Purpose: Postoperative complications and readmission after intestinal resection in Crohn's disease (CD) and ulcerative colitis (UC) have not been characterized in Canadian province-wide studies. We assessed the occurrence of, and risk factors for in-hospital postoperative complications and short-term readmission. Methods: We used Alberta-wide inpatient administrative data from 2002 to 2011, to identify 3197 hospitalizations in patients of all ages with a diagnosis code for CD (International Classification of Disease, 10th version, Canadian edition [ICD-10-CA]: K50.X) or UC (ICD-10-CA: K51.X) and a procedure code for intestinal resection (Canadian Classification of Health Intervention: 1.NK.87.X, 1.NM.87.X, 1.NM.89.X, or 1.NM.91.X). In-hospital postoperative complication was defined as an event with a postoperative diagnosis code that occurred in the same visit as surgery. They were identified from pre-defined ICD-9 codes converted to ICD-10-CA codes; and from ICD-10-CA postoperative complications identified by experienced clinicians. In-hospital postoperative complication occurrence was assessed; age, admission type, surgery technique, and Charlson comorbidity index were evaluated as predictors using a Poisson regression fit to a binomial model. Short-term readmission occurrence was calculated at 30, 60, and 90 days after discharge. Results: Among 2638 and 559 hospitalizations with intestinal resection for CD and UC, respectively, in-hospital postoperative complications occurred in 36% and 34%, respectively. Gastrointestinal, infection, and wound were the most common systems involved, affecting 68%, 27%, and 26% of CD, and 66%, 34%, and 26% of UC, respectively. The following variables were identified as risk factors for in-hospital postoperative complications: age >65 years vs. age <18 years for CD (Risk Ratio [RR]: 1.47; 95% Confidence Interval [CI] 1.02-2.10) and UC (RR: 2.56; 95% CI 1.23-5.29); and >2 vs. no co-morbidities for CD (RR: 1.40; 95% CI 1.06-1.87) and UC (RR: 1.39; 95% CI). Elective vs. emergent admission, and open vs. laparoscopic surgery were significant risk factors for CD and UC (p-values <0.03). The occurrence of short-term readmission after surgery was 9%, 11%, and 13% in CD, and 7%, 10%, and 13% in UC at 30, 60, and 90 days, respectively. Of patients readmitted at 30 days, 59% of CD and 55% of UC patients had a diagnosis code for postoperative complication. Conclusion: Postoperative complications are common in intestinal resections for CD and UC, especially in the elderly, emergently admitted, those with multiple co-morbidities, and open surgery. Future studies evaluating strategies to identify and avert preventable post-operative complications are required to optimize care.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 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".