Risk of post-operative surgical site infections after vedolizumab vs anti-tumour necrosis factor therapy: a propensity score matching analysis in inflammatory bowel disease

K. T. Park, L. Sceats, M. Dehghan, A. W. Trickey, A. Wren, J. J. Wong, R. Bensen, B. N. Limketkai, Kian Keyashian, C. Kin

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Perioperative vedolizumab (VDZ) and anti-tumour necrosis factor (TNFi) therapies are implicated in causing post-operative complications in inflammatory bowel disease (IBD). Aim: To compare the risk of surgical site infections (SSIs) between VDZ- and TNFi-treated IBD patients in propensity-matched cohorts. Methods: The Optum Research Database was used to identify IBD patients who received VDZ or TNFi within 30 days prior to abdominal surgery between January 2015 and December 2016. The date of IBD-related abdominal surgery was defined as the index date. SSIs were determined by ICD-9/10 and CPT codes related to superficial wound infections or deep organ space infections after surgery. Propensity score 1:1 matching established comparable cohorts based on VDZ or TNFi exposure before surgery based on evidence-based risk modifiers. Results: The propensity-matched sample included 186 patients who received pre-operative biologic therapy (VDZ, n = 94; TNFi, n = 92). VDZ and TNFi cohorts were similar based on age, gender, IBD type, concomitant immunomodulator exposure, chronic opioid or corticosteroid therapy, Charlson Comorbidity Index and malnutrition. VDZ patients were more likely to undergo an open bowel resection with ostomy. After propensity score matching, there was no significant difference in post-operative SSIs (TNFi 12.0% vs VDZ 14.9%, P = 0.56). Multivariable analysis indicated that malnutrition was the sole risk factor for developing SSI (OR 3.1, 95% CI 1.11-8.71) regardless of the type of biologic exposure. Conclusion: In the largest, risk-adjusted cohort analysis to date, perioperative exposure to VDZ therapy was not associated with a significantly higher risk of developing an SSI compared to TNFi therapy.

Original languageEnglish (US)
Pages (from-to)340-346
Number of pages7
JournalAlimentary Pharmacology and Therapeutics
Volume48
Issue number3
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

Fingerprint

Surgical Wound Infection
Propensity Score
Inflammatory Bowel Diseases
Tumor Necrosis Factor-alpha
Therapeutics
International Classification of Diseases
Malnutrition
Current Procedural Terminology
Ostomy
vedolizumab
Biological Therapy
Immunologic Factors
Wound Infection
Opioid Analgesics
Comorbidity
Adrenal Cortex Hormones
Cohort Studies
Databases

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Risk of post-operative surgical site infections after vedolizumab vs anti-tumour necrosis factor therapy : a propensity score matching analysis in inflammatory bowel disease. / Park, K. T.; Sceats, L.; Dehghan, M.; Trickey, A. W.; Wren, A.; Wong, J. J.; Bensen, R.; Limketkai, B. N.; Keyashian, Kian; Kin, C.

In: Alimentary Pharmacology and Therapeutics, Vol. 48, No. 3, 01.08.2018, p. 340-346.

Research output: Contribution to journalArticle

Park, K. T. ; Sceats, L. ; Dehghan, M. ; Trickey, A. W. ; Wren, A. ; Wong, J. J. ; Bensen, R. ; Limketkai, B. N. ; Keyashian, Kian ; Kin, C. / Risk of post-operative surgical site infections after vedolizumab vs anti-tumour necrosis factor therapy : a propensity score matching analysis in inflammatory bowel disease. In: Alimentary Pharmacology and Therapeutics. 2018 ; Vol. 48, No. 3. pp. 340-346.
@article{6ab3bce631724618a4bbbf1998a7562b,
title = "Risk of post-operative surgical site infections after vedolizumab vs anti-tumour necrosis factor therapy: a propensity score matching analysis in inflammatory bowel disease",
abstract = "Background: Perioperative vedolizumab (VDZ) and anti-tumour necrosis factor (TNFi) therapies are implicated in causing post-operative complications in inflammatory bowel disease (IBD). Aim: To compare the risk of surgical site infections (SSIs) between VDZ- and TNFi-treated IBD patients in propensity-matched cohorts. Methods: The Optum Research Database was used to identify IBD patients who received VDZ or TNFi within 30 days prior to abdominal surgery between January 2015 and December 2016. The date of IBD-related abdominal surgery was defined as the index date. SSIs were determined by ICD-9/10 and CPT codes related to superficial wound infections or deep organ space infections after surgery. Propensity score 1:1 matching established comparable cohorts based on VDZ or TNFi exposure before surgery based on evidence-based risk modifiers. Results: The propensity-matched sample included 186 patients who received pre-operative biologic therapy (VDZ, n = 94; TNFi, n = 92). VDZ and TNFi cohorts were similar based on age, gender, IBD type, concomitant immunomodulator exposure, chronic opioid or corticosteroid therapy, Charlson Comorbidity Index and malnutrition. VDZ patients were more likely to undergo an open bowel resection with ostomy. After propensity score matching, there was no significant difference in post-operative SSIs (TNFi 12.0{\%} vs VDZ 14.9{\%}, P = 0.56). Multivariable analysis indicated that malnutrition was the sole risk factor for developing SSI (OR 3.1, 95{\%} CI 1.11-8.71) regardless of the type of biologic exposure. Conclusion: In the largest, risk-adjusted cohort analysis to date, perioperative exposure to VDZ therapy was not associated with a significantly higher risk of developing an SSI compared to TNFi therapy.",
author = "Park, {K. T.} and L. Sceats and M. Dehghan and Trickey, {A. W.} and A. Wren and Wong, {J. J.} and R. Bensen and Limketkai, {B. N.} and Kian Keyashian and C. Kin",
year = "2018",
month = "8",
day = "1",
doi = "10.1111/apt.14842",
language = "English (US)",
volume = "48",
pages = "340--346",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Risk of post-operative surgical site infections after vedolizumab vs anti-tumour necrosis factor therapy

T2 - a propensity score matching analysis in inflammatory bowel disease

AU - Park, K. T.

AU - Sceats, L.

AU - Dehghan, M.

AU - Trickey, A. W.

AU - Wren, A.

AU - Wong, J. J.

AU - Bensen, R.

AU - Limketkai, B. N.

AU - Keyashian, Kian

AU - Kin, C.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Background: Perioperative vedolizumab (VDZ) and anti-tumour necrosis factor (TNFi) therapies are implicated in causing post-operative complications in inflammatory bowel disease (IBD). Aim: To compare the risk of surgical site infections (SSIs) between VDZ- and TNFi-treated IBD patients in propensity-matched cohorts. Methods: The Optum Research Database was used to identify IBD patients who received VDZ or TNFi within 30 days prior to abdominal surgery between January 2015 and December 2016. The date of IBD-related abdominal surgery was defined as the index date. SSIs were determined by ICD-9/10 and CPT codes related to superficial wound infections or deep organ space infections after surgery. Propensity score 1:1 matching established comparable cohorts based on VDZ or TNFi exposure before surgery based on evidence-based risk modifiers. Results: The propensity-matched sample included 186 patients who received pre-operative biologic therapy (VDZ, n = 94; TNFi, n = 92). VDZ and TNFi cohorts were similar based on age, gender, IBD type, concomitant immunomodulator exposure, chronic opioid or corticosteroid therapy, Charlson Comorbidity Index and malnutrition. VDZ patients were more likely to undergo an open bowel resection with ostomy. After propensity score matching, there was no significant difference in post-operative SSIs (TNFi 12.0% vs VDZ 14.9%, P = 0.56). Multivariable analysis indicated that malnutrition was the sole risk factor for developing SSI (OR 3.1, 95% CI 1.11-8.71) regardless of the type of biologic exposure. Conclusion: In the largest, risk-adjusted cohort analysis to date, perioperative exposure to VDZ therapy was not associated with a significantly higher risk of developing an SSI compared to TNFi therapy.

AB - Background: Perioperative vedolizumab (VDZ) and anti-tumour necrosis factor (TNFi) therapies are implicated in causing post-operative complications in inflammatory bowel disease (IBD). Aim: To compare the risk of surgical site infections (SSIs) between VDZ- and TNFi-treated IBD patients in propensity-matched cohorts. Methods: The Optum Research Database was used to identify IBD patients who received VDZ or TNFi within 30 days prior to abdominal surgery between January 2015 and December 2016. The date of IBD-related abdominal surgery was defined as the index date. SSIs were determined by ICD-9/10 and CPT codes related to superficial wound infections or deep organ space infections after surgery. Propensity score 1:1 matching established comparable cohorts based on VDZ or TNFi exposure before surgery based on evidence-based risk modifiers. Results: The propensity-matched sample included 186 patients who received pre-operative biologic therapy (VDZ, n = 94; TNFi, n = 92). VDZ and TNFi cohorts were similar based on age, gender, IBD type, concomitant immunomodulator exposure, chronic opioid or corticosteroid therapy, Charlson Comorbidity Index and malnutrition. VDZ patients were more likely to undergo an open bowel resection with ostomy. After propensity score matching, there was no significant difference in post-operative SSIs (TNFi 12.0% vs VDZ 14.9%, P = 0.56). Multivariable analysis indicated that malnutrition was the sole risk factor for developing SSI (OR 3.1, 95% CI 1.11-8.71) regardless of the type of biologic exposure. Conclusion: In the largest, risk-adjusted cohort analysis to date, perioperative exposure to VDZ therapy was not associated with a significantly higher risk of developing an SSI compared to TNFi therapy.

UR - http://www.scopus.com/inward/record.url?scp=85049794025&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049794025&partnerID=8YFLogxK

U2 - 10.1111/apt.14842

DO - 10.1111/apt.14842

M3 - Article

AN - SCOPUS:85049794025

VL - 48

SP - 340

EP - 346

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 3

ER -