P299. Are regular repeated endoscopies necessary in patients with inflammatory bowel diseases?
D.H. Kim1, S.M. Yim1, A.R. Choi1, H.J. Lee1, H.W. Jang1, S.H. Jung1, S.J. Park1, S.P. Hong1, T.I. Kim1, W.H. Kim1, J.H. Cheon1, 1Yonsei University College of Medicine, Internal Medicine, Seoul, South Korea
There are controversies about the role for regular repeated endoscopy in patients with inflammatory bowel diseases (IBD). The present study aimed to evaluate whether repeated endoscopies would be beneficial in improving outcomes of patients with IBD.
Patients who had been initially confirmed as having IBD at a single institution between January 2004 and December 2007 were regularly followed and included in this study. Their clinical and endoscopic data including types of endoscopy, indications of follow-up endoscopy, endoscopic and histological findings were retrospectively evaluated. Clinical impacts as assessed by the presence or absence of management change after endoscopy and cumulative hospitalization rate were compared between two groups classified according to the interval of follow-up endoscopy (within three years or not).
A total of 159 patients with IBD were enrolled (59 [37.1%] patients with Crohn's disease (CD), 100 [62.9%] with ulcerative colitis (UC); 110 [69.2%] males). The median duration between initial endoscopy and first follow-up endoscopy was 1018 days (38–2161). The overall management change after follow-up endoscopy was found to be “changed aggressively” in 29 (18.2%), “changed lightly” in 4 (2.5%), “not changed” in 74 (46.5%), and “changed to other diseases” in 5 (3.1%). Management change rate was numerically higher in the early follow-up group, but this was not statistically significant (0.087 in CD and 0.086 in UC, respectively). The presence of any indications for follow-up endoscopy revealed as a significant predictor for hospitalization risk in patients with UC (HR 4.649; 95% CI 1.574–13.730; P = 0.005) but not in those with CD. However, there was no significant difference in cumulative hospitalization hazards between early and late follow-up groups. (0.453 in CD and 0.702 in UC, respectively).
The duration between initial evaluation and first follow-up endoscopy of any indication may not have much significance on the overall clinical course and outcomes in patients with IBD.