FP2.5 - Predictors for anastomotic leak (AL) in inflammatory bowel disease (IBD) patients and its associated postoperative (PO) complications; A cohort of a single institution experience

Abstract Introduction IBD patients are highly susceptible to PO morbidities. This study aimed to look at the predictors of AL and the associated morbidities during hospital stays to increase the awareness of these patients. Methods A 5-year retrospective study in DGH. All variables were evaluated:patient-dependent (Age, Gender, BMI, ethnic group, comorbidities),disease-dependent (type of IBD, disease location, disease duration), surgery-dependent (duration, CEPOD type, approach, type of resection),Postoperative(CRP level, VTE, ITU admission, LOS, complications).All data were analysed using SPSS22, and Chi-square test. Results 131 patients were admitted for IBD resection. Median age 37 years. 76 (58%) were female, Chron’s disease was 98 (74.8%). 101 (77.1%) were done laparoscopically, 87 (66.4%)were elective, and the median LOS was 7days.63 (48.1%) has bowel anastomosis and 15 (23.8%) have AL. The median CRP on PO day3 for AL patients was 118. There was no significant association between PO day3CRP and IBD type with AL (P=0.4, 0.7); however, DVT and PE were associated with AL (P=0.001 and 0.039). Patients with AL had a high tendency for ITU admission with longer LOS (P=0.000).Long stays were seen in patients with leaks post-emergency than elective resections (P=0.047, 0.112). AL was associated with chest infection (P=0.001), collection (P=0.006),wound infection (p=0.000), and a higher rate of re-operation within 30 days (p=0.019). Conclusion PO day3CRP is not an independent predictor for AL. Our cohort of IBD patients who had bowel anastomosis showed a significant correlation between VTE and AL.AL was associated with chest and wound infections, high chance of a long ITU stay and subsequently, a long hospital stay. IBD patients with AL are vulnerable to VTE so need high care on these regards.