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P260 Disease duration in Crohn’s disease is a strong determinant for having a colectomy in geriatric population

H. Htet*1, T. Mudege1, S. Hoque1

1Whipps Cross Hospital, Barts Health NHS Trust, London, UK

Background

Geriatric population is swiftly growing in most developed countries. Looking after inflammatory bowel disease (IBD) in elderly population has become a clinical challenge due to their co-morbidities, frailty, polypharmacy with multiple drug interactions. In our study, we evaluate the clinical course, treatment, and outcome in our geriatric IBD population in a large district general hospital.

Methods

We identified an IBD geriatric group with age 65 and above from our existing database from 2014 onward. Data were extracted from electronic database. Extracted data included gender, age of diagnosis, duration of disease, disease characteristics using Montreal classification, and surgical outcomes. χ2-test was performed on non-parametric data using R studio program.

Results

Since 2014, we identified 105 IBD patients with age above 65 years. Forty-one out 105 (39%) have Crohn’s disease. Sex ratio is equally distributed (M:F= 21:20).

Boxplot of age, age of diagnosis, and disease duration.

Age ranges from 65 to 90 with median age of 71. Age of diagnosis ranges from 23 to 82 with median age of 59. Disease duration ranges from 0 to 58 years with a median age of 14.

Disease location, n = 41.

Of 41, 12 (29%) had colectomies and 8 (67%) has L1 disease and 4 (33%) had L3 disease.

Colectomy is associated with disease duration of more than 10 years (29% vs. 0%, χ2 = 5.94, p value = 0.015). However, there is no statistically significant association between colectomies and age of disease onset age (<65 years) (33% vs. 13%, p = 0.47) or disease behaviour (stricturing and stenotic vs. non-structuring and non-stenotic) (47% vs. 19%, p = 0.13).

Conclusion

In our cohort of Crohn’s disease, patients aged above 65 years, regardless of the age of disease onset, longer disease duration is associated with colectomies mainly in L1 and L3 disease.