P264 Assessing the risk for an intra-abdominal abscess in patients with Crohn's disease presenting to the emergency department
T. Khoury*1,2, S. Daher3, M. Massarwa3, W. Hazou3, D. Hackimian3, A. A. Benson3, E. Viener3, A. Mari2, W. Sbeit1, M. Mahamid2, E. Israeli3
1Galilee Medical Center, Institute of Gastroenterology and Liver Diseases, Naharia, Israel, 2The Nazareth Hospital, EMMS, Gastroenterology and Endoscopy United, Nazareth, Israel, 3Hadassah University Hospital, Ein Kerem, Institute of Gastroenterology and Liver Diseases, Jerusalem, Israel
The aim of the present study was to generate a simple non-invasive scoring model to predict the presence of an intra-abdominal abscess in Crohn’s disease (CD) patients who present to the emergency department with disease exacerbation.
We performed a retrospective case–control study at two Israeli hospitals (Hadassah Medical centre in Jerusalem, and Nazareth Hospital in Nazareth) from January 2010 to 30 May 2018. Inclusion criteria included patients with an established diagnosis of CD and patients who had abdominal computed tomography or magnetic resonance imaging performed. Patients were excluded if they had IBD-undefined, severe liver, or haematological diseases.
Three hundred and twenty-two patients were included; of these, 81 patients (25%) were diagnosed with an intra-abdominal abscess. In univariate analysis, ileo-colonic location (OR 1.88, 95% CI 1.131–3.12,
|Low cut-off ≤7||Intermediate cut-off >7 and ≤9||High cut-off >9||Total|
|Abscess −ve\Abscess +ve||146\11||50\41||20\38||234\72|
|Positive predictive value||41%||65%|
|Negative predictive value||93%||86%|
|Likelihood ratio (+)||2.24||5.89|
|Likelihood ratio (−)||0.24||0.52|
|Interpretation||Absence of an abscess (93% certainty)||Presence of an abscess (65% certainty)|
Predictive value of the scoring system. https://planner.smart-abstract.com/ecco2019/submission/en/abstract/12120/content#
We recommend incorporating this scoring model into daily clinical practice in the ED as an aid for stratifying CD patients with low or high probability for presence of an intra-abdominal abscess.
1. Khoury T. Predictive value of the scoring system. 2018.