Su1314 Presence of Stenosing and Penetrating Lesions at MRI but Not Deep Ulcers at Endoscopy Predicts Surgery Requirements in Crohn's Disease in the Era of Biologics

diagnosis was 32 years (SD=14.5)and 49% were women.Variables included in the Cox model included: small bowel disease (HR 2.12,, left colonic disease (HR 0.73, CI 0.49-1.09),perianal disease (HR 4.12, logASCA (HR 1.35, logCbir1 (HR 1.29,, logANCA (HR 0.77, HR 0.62-0.95),NOD2 frameshift mutation/SNP13 (HR 2.13,) and the interaction term perianal & logASCA (HR 0.63, CI 0.42-0.94).Medication exposure was not associated with time to complication.The Harrell's C (concordance index)=0.73.When applied to the two external validation cohorts, the concordance index was 0.76 and 0.74, respectively for pediatric and adult patients.The SDA web interface displaying the individualized risk of a complication was easily interpreted by patients.Conclusion: We have developed a web-based patient communication tool to display an individualized predicted outcome for adult patients with Crohn's disease based on clinical, serologic and genetic variables.Importantly, the model was validated in two independent patient cohorts.This model can be used to help providers and patients make personalized decisions about treatment options.