P299 Is quality of life different between Crohn’s disease patients submitted to early surgery or immunosuppression?
R. Barosa*, M. Patita, G. Nunes, C. Carreira, C. Cruz, C. Boal, A. I. Vieira, J. Freitas
Hospital Garcia de Orta, Gastroenterology, Almada, Portugal
Quality of life (QoL) is a subjective index that provides an important insight into patients’ life satisfaction and capacity. We aimed to compare long-term QoL of Crohn’s disease (CD) patients submitted to immunosuppression (IS) or surgery in the first 6 months after diagnosis.
Observational cross-sectional study including all consecutive CD adult patients followed in inflammatory bowel disease outpatient clinic submitted to IS and/or surgery in the first 6 months. The McMaster Inflammatory Bowel Disease Questionnaire (IBDQ) was used to measure QoL and was applied by phone interview or online form. Demographic and clinical data were collected from patients’ medical records. Global disability was defined as in the EASY study.1
Included were 47 patients (10 refused participation or were lost to follow-up). The median follow-up was 9 years (IQR 6.25–12.0). The mean age was 40.9 ± 12.1 years old; 58.3% were female, and the majority was diagnosed before 40 years (A2 = 77.6%). Further, 72.2% were on current IS and 22.2% of the patients were submitted to early surgery. Patients submitted to early surgery had a trend for higher total IBDQ score (191 vs 185; p = 0.079) but lower emotional score (69 vs 72, p = 0.067). Patients older than 40 years and submitted to early surgery had no significant higher IBDQ score (182 vs 179, p = 0.178) and lower emotional and social IBDQ values (30 vs 33, p = 0.244 and 67 vs 71, p = 0.251). There was no difference between early IS or surgery groups when applying an IBDQ cut-off of 168 (p = 0.584). There was no significant differences in IBDQ and its sub-scores between patients with or without current IS nor between patients with and without global disability.
Long-term QoL might not be altered in patients submitted to early surgery or early IS. Emotional dimension as evaluated in the IBDQ might be inferior in patients submitted to early surgery vs IS. In the modern CD management era, the ideal timing and patient for CD surgery needs to be studied further in terms of outcomes, including QoL.
 Magro F, Coelho R, Fernandeset S, et al. EArly SurgerY or Immunosuppression - EASY study. ECCO Congress 2015.