P153. Is the intestinal bowel disease more severe in diagnosed elderly patients?
C. García Caparrós1, P. Ruiz Cuesta2, V. García Sánchez3, J. Jurado4, F. Gomez Camacho2
1Reina Sofía Hospital, Córdoba, Spain; 2Reina Sofia Hospital, Cordoba, Spain; 3Reina Sofia Hospital, Digestive Unit, Cordoba, Spain; 4Reina Sofia Hospital, Córdoba, Spain
Background: The inflammatory bowel disease (IBD) may incidence in patients between 6070 years old. Elderly patients have unique characteristics which may bear into complications related to the disease and its treatments. These days little data are available about the severity of the disease in this population. Our aim was to determine the severity in old-aged patients.
Methods: Retrospective, observational, control-case study. Diagnosed IBD patients with >60 years of age (cases) were identified and for every one of them, two randomized diagnosed patients were selected between 2040 years (control patients) through the IBD local registry database, ENEIDA. Three years after the diagnosis, a complicated or severe disease was defined when the patients presented a fistulizing or stenosing disease in Crohn's disease cases and complications such as abscesses, toxic megacolon, serious bleeding or perforations; need for immunomodulators (IMM) or biological therapy, subsequent surgery and mortality related to the disease and its treatments. Results were analyzed using the statistic program SPSS version 13.0 for Windows.
Results: 220 patients were included in whom: 72 cases (77.8% Ulcerative Colitis (UC) and 22.2% CD, median age of 74 años±6.1, range of 6291) and 148 controls (54.7% UC and 45.3% CD, median age of 31.8 years ± 5 range of 2240). Previous cases defined as severe disease were analyzed. A total of 153 diagnosed patients 153 had no severe disease (59 cases and 94 controls) and 67 patients had a severe disease (13 cases and 54 controls). 39% of control patients presented a severe disease while 18% of cases revealed significantly statistical differences. In analyzed evidences related to complications transcended the presence of CD fistulizing disease (p = 0.024) and the need of IMM and biologicals (p = 0.0103) for the control group while the presence of serious bleeding was more frequent in the case group (p = 0.023). Pharmacological adverse effects were analyzed but no significantly statistical differences were found.
Conclusions: Elderly IBD patients do not present a severe disease compared to younger patients after the early years, although they present more bleeding complications. As a whole, young patients present a severe disease with more therapeutical requirements at the expense of IMM and biologicals.