P823 Biologic Penetration, hospitalization rates and need for major abdominal surgery in inflammatory bowel diseases: a comparative observational study between pediatric and adult patients

Abstract

Background There is lack of epidemiological data in regard to the accurate situation of Inflammatory Bowel Disease (IBD): Crohn’s disease (CD) and ulcerative colitis (UC) in Brazil. It is known that both diseases' progression is variable and the chronic iinflammation results in structural bowel damage. Comparative data between adult and pediatric patients in the IBD field, regarding different outcomes, is lacking globally. We aimed to analyze the proportion of use of biologicals, need for major abdominal surgery and hospitalizations in CD and UC , between adult and pediatric patients. Methods Cross-sectional and multicenter study. Data was collected from all consecutive IBD patients seen as outpatients or admitted to hospital, from 2015 – 2021, in two IBD tertiary centers from a capital from south Brazil. We included all patients with clinical, endoscopic, radiological or histological diagnosis of CD and UC. Patients with unclassified colitis or without available data in medical records for investigating variables of interest were excluded. Patients were classified in two main groups (CD and UC) and in two subgroups each, according to age range: adults and pediatrics. Analyses were made by frequency, proportion, Fisher’s exact test and Chi-squared test, through software IBM SPSS Statistics 28. Results Eight hundred and twenty-nine patients were included: 509 with CD (378 adults/131 pediatrics) and 320 with UC (225/95). There was significantly difference between diseases in the proportion of biological use 75.0% in CD and 31.6% in UC (p<0.001), surgeries 49.7%/14,1% (p<0.001) and hospitalizations 58.9%/30.9% (p<0.001), respectively. In CD, there was no difference regarding biological use (80.2% in pediatric group vs. 73.3% in adults; p=0.129), surgeries (46.6% vs. 50.8%; p=0.419) and hospitalizations (64.9% vs. 56.9%; p=0.122). There was significantly difference in biological use (40.0% vs. 28.0%; p=0.048) and hospitalizations (47.4% vs. 24.0%; p< 0.001) in UC and there was no difference regarding surgery necessity between age ranges (17.9% vs. 12.4%; p=0.219). Conclusion There was a higher proportion of biological use, surgery and need for hospitalizations in CD as compared to UC. Comparing age ranges, pediatric patients with UC used more biologicals and required more hospitalizations than adults, but there was no difference in the need for abdominal surgery. In CD, there was no significant difference in the three main outcomes, between the age groups.