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P661 Different phenotypical characteristics in Romanian IBD patients with rural vs. urban residence: Results of a nationwide multicentric cohort

R. Iacob*1, R. Vadan1, I.E. Csiki1, L. Gheorghe1, C. Gheorghe1, C. Cijevschi2, A. Trifan2, D. Dobru3, M. Tantau4, A. Goldis5, G. Constantinescu6, M. Diculescu1

1Fundeni Clinical Institute, Digestive Diseases and Liver Transplantation Center, Bucharest, Romania, 2Gastroenterology and Hepatology Institute , Gastroenterology, Iasi, Romania, 3Municipal Hospital Targu Mures, Gastroenterology, Targu Mures, Romania, 43rd Medical Clinic Cluj-Napoca, Gastroenterology, Cluj-Napoca, Romania, 5District Hospital, Gastroenterology, Timisoara, Romania, 6Floreasca Emergency Hospital, Gastroenterology, Bucharest, Romania

Background

According to last population statistics, Romania has a population of over 20 million inhabitants out of which only 54% reside in urban areas. Different residential areas might indicate different environmental factors influencing phenotypical presentation of IBD patients in our country.

Methods

We have investigated phenotypical characteristics of Romanian IBD patients using the the IBDPROSPECT Referral Center Database, a web-accessed database implemented in our Country in order to facilitate collection of significant IBD epidemiological data Nationwide. A total of 1481 patients from 15 referral centers nationwide were included in the analysis during the time period 2006-2014. Only data at first presentation was analyzed.

Results

There were 73.8% of cases residing urban areas, with male predominance (53%). There was a significantly higher proportion of patients diagnosed with UC in rural vs urban areas - 63.7% vs 56.5% (p=0,03). Significantly more moderate to severe cases were from rural areas of residence - 62% vs 49.5% (p=0,0004). Similar differences in severity of flare were registered for both UC and CD cases, in subgroup analyses. No significant differences in rural vs urban residents were identified according to different phenotypical features of Montreal classification. Patients from rural areas presented with lower digestive hemorrhage more frequently - 20,4% vs 14% (p=0.006), however, extraintestinal manifestations were more frequently encountered in patients with urban residence - 16,7% vs 10,9% (p=0,01).

Conclusion

The analysis of our multicentric referral center cohort indicates that Romanian IBD patients residing in rural areas represent approximately 27%, have a higher incidence of UC and a more severe presentation of the disease.

Acknowledgement: This abstract was submitted on behalf the IBDPROSPECT Study Group.