P819 Postoperative prophylaxis prevents surgical and severe endoscopic recurrence after primary ileocecal resection in CD patients
Bibliographic record
Abstract
Abstract Background Prophylactic medication following ileocecal resection (ICR) is recommended in patients with Crohn’s disease (CD), particularly in patients at increased risk of recurrence. This study aimed to evaluate the effect of prophylactic medication on long-term prognosis. Methods A retrospective cohort study was performed in patients with CD who underwent a primary ICR. Patients were divided into two groups: prophylaxis (i.e. initiation of prophylactic medication<12 weeks following ICR) versus no prophylaxis. The primary and secondary outcomes were surgical recurrence and severe endoscopic recurrence (modified Rutgeerts score ≥ i3). To compare the outcomes between both groups, inverse propensity score-weighted comparison was used to adjust for confounding and selection bias. The survival and association between prophylaxis and both outcomes were assessed with Kaplan-Meier analyses and Cox proportional hazard models. Results 811 patients underwent an ICR [median follow-up 5.8 years (IQR 2.5 – 10.7)](Table 1). Prophylaxis was initiated in 297/811 [37%] patients. In 364/514 [71%] patients without prophylaxis, medication was started after median follow-up 15 months [IQR 7.2 – 46.5]. Cumulative rates of surgical and endoscopic recurrence at 1, 2, 5 and 10 years were significantly lower in patients with prophylaxis versus no prophylaxis [1%, 3%, 9% and 19%, vs. 3%, 4%, 11% and 23%, p < 0.05] and [4%, 8%, 15% and 27% vs. 10%, 16%, 25% and 40%, p < 0.01]. Propensity-scored weighted analysis showed that patients treated with prophylaxis were less likely to experience surgical recurrence [aOR 0.52; 95% CI 0.33 – 0.82] and severe endoscopic recurrence[aOR 0.53; 95% CI 0.35 – 0.81]. In multivariable analysis, prophylaxis was identified as protective factor for surgical [aHR 0.67, 95% CI 0.45 – 0.99] and severe endoscopic recurrence [aHR 0.54, 95% CI 0.37 – 0.78] (Table 2). Conclusion Surgical and severe endoscopic recurrence up to 10 years following primary ICR are significantly reduced in patients with CD who received prophylaxis as compared to no prophylaxis. Prophylaxis was associated with the prevention of surgical and severe endoscopic recurrence.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".