Postoperative mortality after surgery for inflammatory bowel disease in the era of biological agents: A population-based study in Southern Europe.

BACKGROUND:Despite the efficacy of biological agents, surgery is still required for a large percentage of patients with inflammatory bowel disease (IBD). AIMS:To assess the postoperative mortality rates and associated risk factors in IBD patients in a population-based setting in the era of biological agents. METHODS:This is a population-based longitudinal study including all patients diagnosed with IBD in Catalonia who underwent intestinal resection or colectomy between 2007 and 2016, identified from the Catalan Health Surveillance System database. Logistic regression was used to calculate the adjusted odds ratio for postoperative in-hospital and 30-day mortality. Data for Crohn's disease (CD) and ulcerative colitis (UC) were analysed separately. RESULTS:A total of 1,660 interventions for CD (69%) and 738 for UC (31%) were performed at 55 centres. In-hospital and 30-day postoperative mortality rates were 2.1% and 2.5% for CD, and 5.4% and 6.4% for UC, respectively. In the multivariate logistic regression analysis, comorbidity was associated with in-hospital and 30-day postoperative mortality in CD and UC, whereas age was only associated with mortality in CD and a non-laparoscopic surgical approach with UC. CONCLUSIONS:In the era of biologicals, the postoperative mortality rate for IBD depends mostly on co-morbidities and age.