P2586 - Decade-Long Analysis of Crohn's Disease and Ulcerative Colitis: Disease Burden, Phenotypic Differences, and Ethnographic Insights in a Tertiary Care Center

Raguraj Chandradevan, MBBS¹, Chakravarthy Nulu, MS¹, Brandon Garten, BS¹, Gaurav Gopu, ², Aisha Naushad, MS¹, Sandeep Yerraguntla, ¹, Michael Temple, MD¹, Bobak Moazzami, MD³, Humberto Sifuentes, MD^4
1Medical College of Georgia at Augusta University, Augusta, GA; ²Medical College of Georgia at Augusta University, Cumming, GA; ³Northside Hospital Gwinnett, Atlanta, GA; ⁴Augusta University, Augusta, GA

Introduction: Despite advances in medical treatment, many patients with Inflammatory Bowel Disease (IBD) require surgery. We aim to evaluate the surgical interventions among patients admitted to our tertiary hospital within the last 10 years.

Methods: We conducted a retrospective review (2011-2022) of patients diagnosed with IBD admitted to the hospital for elective or urgent/emergent surgical procedures (IRB study 2089342-4). Analyzed patient data included BMI, age, race, length of hospital stays, surgeries performed during admission, presence of perianal disease, extent of Ulcerative Colitis (UC) disease, Crohn's Disease (CD), phenotypes, duration since diagnosis, extra-intestinal manifestations, current and past treatment, establishment of care at our clinic, and insurance status.

Results: Ninety-eight patients aged 16-79 underwent IBD-related surgeries, with one major procedure considered per patient. The cohort was 56% female and 44% male; racially, 50% were White, 49% Black, and 1% Asian. Black patients had a female predominance (60%), while White patients had balanced gender representation. Median BMI was 26, and the average hospital stay was 7.8 days. Of the patients, 83 had Crohn's disease (CD) and 15 had ulcerative colitis (UC). Among CD patients, 71% had ileocolonic involvement, 71% had penetrating disease, 27% had the L3B3p phenotype, and 26% had L3B3. In UC patients, 13 had pancolitis, one left-sided colitis, and one proctitis. The average time from diagnosis to surgery was 8.3 years. Surgery types were mostly large bowel (40%) and small and large bowel resections (30%). Pre-surgery treatments included anti-TNF (73%), IL-12/IL-23 blockers (37%), and α4β7 integrin blockers (11%). Insurance coverage was 50% non-private, 40% private, and 10% self-pay. Thirty percent had extraintestinal manifestations such as arthropathy, pyoderma gangrenosum, and aphthous ulcers. No significant differences were found in hospital stay, phenotypes, BMI, diagnosis-to-surgery time, or treatment among racial groups.

Discussion: Twenty percent of patients with UC and 80% with CD will undergo surgery in their lifetime. Our cohort reflects this, with an average diagnosis-to-surgery time of 8.3 years. Arthralgia was common among surgical patients. No significant variation in surgical outcomes, phenotypes, treatments, or diagnosis-to-surgery time was found between racial groups. Despite biologic treatments, patients with complicated ileocolonic CD and pancolitis in UC showed a high disease burden.



Disclosures:


Raguraj Chandradevan, MBBS¹, Chakravarthy Nulu, MS¹, Brandon Garten, BS¹, Gaurav Gopu, ², Aisha Naushad, MS¹, Sandeep Yerraguntla, ¹, Michael Temple, MD¹, Bobak Moazzami, MD³, Humberto Sifuentes, MD⁴. P2586 - Decade-Long Analysis of Crohn's Disease and Ulcerative Colitis: Disease Burden, Phenotypic Differences, and Ethnographic Insights in a Tertiary Care Center, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.