P717 Predictive factors for unfavourable disease course in inflammatory bowel diseases (IBD): data analysis of almost 1 000 patients from a Hungarian tertiary IBD centre
K. Farkas1, T. Nyári2, A. Bálint1, R. Bor1, A. Milassin1, M. Rutka*1, Z. Szepes1, F. Nagy1, T. Molnár1
1University of Szeged, First Department of Medicine, Szeged, Hungary, 2University of Szeged, Department of Medical Physics and Informatics, Szeged, Hungary
Inflammatory bowel diseases (IBD) (Crohn’s disease [CD] and ulcerative colitis [UC]), are chronic relapsing disorders of unknown aetiology. The aim of this study was to determine demographic features, disease phenotypes, and medical and surgical therapies in our IBD patients, and to identify predictors of disease outcome in CD and UC.
Data on demographic and clinical characteristics of the patients were analysed from the IBD registry of the First Department of Medicine, University of Szeged. The study period was between January 2007 and March 2015. Unfavourable disease outcome was defined as active disease, with or without extraintestinal complications, or perianal manifestations affecting the patients’ quality of life, and the need of biological therapy and/or major surgery.
Data of 911 IBD patients (428 CD; 483 UC) were analysed. The mean lag time between onset of symptoms and diagnosis was 1.33 years in CD vs 0.74 years in UC (p = 0.01). Further, 40% of the patients received biological therapy, and 301 patients underwent surgery, which was required more frequently for CD than UC. Surgery was more common in CD patients with ileal location and penetrating behaviour. In UC, more severe disease onset determined by pMayo score predicted unfavourable disease course. Age above 40 years at diagnosis predicted surgery, and age below the 40 years predicted to the need of biological therapy in CD and UC. Diagnostic delay of more than 1 year and appendectomy predicted unfavourable disease outcome in both CD and UC patients.
This analysis revealed that at diagnosis of IBD in a referral centre, factors predictive of more severe course are age; more than 1 year of diagnostic delay; disease activity at diagnosis in UC, CD, and ileal location; and penetrating behaviour. Use of thiopurines seemed to be protective in UC patients.