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P293 Delayed timing of post-operative colonoscopy within 1 year does not predict a more severe Rutgeerts score

S. Singh*1, J. Pang2, 3, C. Seow1, 2, 4, Y. Leung1, 2, 4, K. Novak1, 2, 4, R. Panaccione1, 2, 4, G. Kaplan1, 2, 3, 4

1University of Calgary, Gastroenterology, Calgary, Canada, 2University of Calgary, Foothills Campus, Department of Medicine, Calgary, Canada, 3University of Calgary, Community Health Sciences, Calgary, Canada, 4University of Calgary, Inflammatory Bowel Diseases Clinic, Calgary, Canada

Background

Crohn’s disease (CD) is a chronic condition that often recurs after intestinal resection. There is no definitive evidence that suggests the ideal time to perform a post-operative colonoscopy to evaluate for CD recurrence, although commonly colonoscopy is done within 6–12 months from intestinal resection. We hypothesise, that within a 1-year period, delayed colonoscopy would result in a higher, and thus more severe, Rutgeerts score.

Methods

We identified 67 CD patients who underwent their first intestinal resection, between 2005 and 2015 and subsequently had a post-operative colonoscopy within 1 year. Surgical procedures, surgical dates, and colonoscopy dates were verified using a provincial electronic health care record. Rutgeerts scores were determined by 2 independent reviewers, and discrepancies were rectified by a third expert reviewer. A logistic regression model was used to evaluate the effect of time from surgery (in months) to colonoscopy on post-operative recurrence, after adjusting for age and sex. Post-operative recurrence was defined as Rutgeerts scores, which were grouped into 2 categories: mild (i0 or i1) and moderate-to-severe (i2, i3, or i4). Odds ratios (OR) with 95% confidence intervals (CI) were assessed.

Results

Male sex was significantly associated with a moderate-to-severe Rutgeerts score (OR = 3.0 [95 % CI, 1.06–8.64], p < 0.05). However, age (OR = 1.0 [95% CI, 0.98–1.05]) and timing of post-operative colonoscopy (OR = 0.9 [95% CI, 0.80–1.06]) were not associated with a moderate-to-severe Rutgeerts score (Figure 1).

Figure 1. Male sex is associated with higher Rutgeerts score.

Conclusion

Within a 1-year period, delayed colonoscopy was not significantly associated with a higher Rutgeerts score. Males were more likely to have a higher Rutgeerts score, indicating greater degree of intestinal inflammation. Future studies are necessary to assess whether clinicians might vary the timing of a post-operative colonoscopy based on sex.