Impact of inflammatory bowel disease on outcomes of colorectal cancer patients undergoing open resection.

Abstract

3562 Background: Colorectal cancer(CRC) is, at present, the fourth most common cause of cancer in the United States, with more than 140,000 new cases and 52,000 deaths yearly. Patients with inflammatory bowel disease(IBD) are at increased risk of CRC secondary to the pro-neoplastic effects of chronic mucosal inflammation. Open resection is one of the treatment modalities among CRC patients. Research evaluating the impact of IBD on the short-term outcomes of open resection is limited. Methods: The National Inpatient sample was utilized to identify open resection procedures among colorectal cancer patients through International Classification of Diseases, 10th edition (ICD-10) codes. Our study contained patients ages 18 and older. We created two groups of patients consisting of cases with and without a history of IBD. Descriptive statistics were conducted for patient demographics and pre-existing comorbidities. We reported the adjusted odds ratio(aOR) and their 95% confidence intervals for differences in surgical and post-surgical complications. Results: This study investigated 318115 open resections among colorectal cancer patients, which involved 3675(1.2%) with IBD. The cases of IBD contained a younger sample with a mean age of 60.95 years, while our non-IBD group had a mean age of 66.95 years(p < 0.01). In addition, IBD patients expressed a lower mean Charlson Comorbidity Index(CCI) score of 4.21(vs. 4.34, p < 0.01). Our IBD group presented with higher aOR of severe sepsis with septic shock (1.224, 95% CI 1.030-1.455, p = 0.022), acute kidney injury(AKI)(1.172, 95% CI 1.059-1.297, p < 0.01), cardiopulmonary resuscitation (CPR)(2.148, 95% CI 1.437-3.212, p < 0.01), and wound infection(1.377, 95% CI 1.139-1.664, p < 0.01). On the other hand, IBD was linked with lower odds of bleeding(aOR 0.808, 95% CI 0.686-0.952, p = 0.011) but was more likely to undergo blood transfusion(aOR 1.153, 95% CI 1.036-1.284, p < 0.01). However, events of acute respiratory failure (aOR 1.024, 95% CI 0.877-1.195, p = 0.767), postoperative pneumothorax(aOR 1.286, 95% CI 0.684-2.417, p = 0.436), use of mechanical ventilation(aOR 1.181, 95% CI 0.996-1.400, p = 0.056), vasopressors (aOR 1.012, 95% CI 0.780-1.315, p = 0.926), and all-cause mortality (aOR 1.026, 95% CI 0.808-1.304, p = 0.831) did not differ. Conclusions: Among CRC patients undergoing open resection, patients with IBD were younger and had higher odds of septic shock, AKI, CPR, wound infection, and blood transfusion. Although we failed to find differences in short-term mortality, it is crucial to conduct long-term studies to evaluate responses and relapses following open resection and post-discharge complications.