Optimizing perioperative Crohn's disease management: Role of coordinated medical and surgical care

Table 1 Comparison of patients with > 4-wk, within 4-wk and no gastrointestinal follow-up n (%)

Demographics	4 wk follow-up with GI (n = 36)	> 4 wk follow-up with GI (n = 35)	No follow-up or lost to GI follow-up (n = 17)
Male	24 (67)	18 (51)	6 (35)
Receiving all care at Johns Hopkins Hospital	22 (61)a	22 (63)	4 (24)
Age at operation	33.6 +/- 10.8ac	44.5 +/- 15.2	44.5 +/- 14.9
Laparoscopic Technique	20 (56)	21 (60)	5 (29)
Preoperative Admission within < 60 d	11 (31)	6 (17)	4 (24)
Current smoker	8 (22)	13 (37)	2 (12)
Disease phenotype
B1	1 (2.8)	1 (2.9)	1 (5.9)
B2 Stricturing	19 (53)	24 (69)	12 (71)
B3 Penetrating	16 (44)	10 (29)	4 (24)
Perianal disease	4 (11)	6 (17)	4 (24)
Preoperative Therapy
Preoperative antibiotics	16 (44)	10 (29)	4 (24)
Preoperative ASA	19 (53)	19 (54)	8 (47)
Preoperative Steroids	17 (47)	13 (37)	5 (29)
Preoperative IMM	9 (25)	5 (14)	5 (29)
Preoperative anti-TNF	20 (56)c	11 (31)	7 (41)
Preoperative TPN	9 (25)	3 (8.6)	3 (18)
Mean Length of Hospital Stay	8.5 +/- 5.5c	6.5 +/- 5.5	9.8 +/- 4.9
Postoperative Readmission within 30 d	6 (167)	4 (11)	4 (24)
Any Postoperative Complication	6 (17)	8 (23)	1 (5.9)
Postoperative Medical Complication	5 (14)	7 (20)	1 (5.9)
Postoperative Surgical Complication	2 (5.6)	3 (8.6)	0 (0)

^aP < 0.05 vs > 4 wk follow-up with GI;

^cP < 0.05 vs no follow-up or lost to gastrointestinal follow-up. GI: Gastrointestinal; anti-TNF: Anti-tumor necrosis.

Table 2 Comparison of postoperative recurrence risk subgroups: 4-wk follow up to gastrointestinal vs colorectal surgery and 12 mo care measures n (%)

	Postoperative follow-up at 4 wk			Postoperative 12 mo
	With GI	With colorectal surgery	P-value	Colonoscopy	Medical therapy resumption
Overall (n = 88)	36 (40.9)	81 (92.0)	< 0.0001	47 (53.4)	66 (75.0)
Patient subgroups:
Less than 10 yr since diagnosis or B2 disease (n = 35)	13 (37.1)	33 (94.3)	< 0.0001	20 (57.1)	18 (51.4)
2 or more surgeries (n = 38)	16 (42.1)	36 (94.7)	< 0.0001	21 (84.0)	25 (65.8)
B3 disease (n = 30)	16 (53.3)	28 (93.3)	0.0009	15 (50.0)	16 (53.3)
Current smokers (n = 23)	8 (34.8)	21 (91.3)	0.0001	14 (60.9)	17 (73.9)
Preoperative anti-TNF (n = 38)	20 (52.6)	35 (92.1)	0.0002	20 (52.6)	25 (65.8)
Preoperative Immunomodulator (n = 19)	9 (47.4)	19 (100.0)	0.0004	10 (52.6)	12 (63.2)
Preoperative steroids (n = 35)	17 (48.6)	33 (94.3)	< 0.0001	20 (57.1)	26 (74.3)

anti-TNF: Anti-tumor necrosis; GI: Gastrointestinal.