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

Jennifer L. Bennett, Christina Y. Ha, Jonathan Efron, Susan L Gearhart, Mark Lazarev, Elizabeth C. Wick

Research output: Contribution to journalArticle

Abstract

AIM: To investigate rates of re-establishing gastroenterology care, colonoscopy, and/or initiating medical therapy after Crohn's disease (CD) surgery at a tertiary care referral center. METHODS: CD patients having small bowel or ileocolonic resections with a primary anastomosis between 2009-2012 were identified from a tertiary academic referral center. CD-specific features, medications, and surgical outcomes were abstracted from the medical record. The primary outcome measure was compliance rates with medical follow-up within 4 wk of hospital discharge and surveillance colonoscopy within 12 mo of surgery. RESULTS: Eighty-eight patients met study inclusion criteria with 92% (n=81) of patients returning for surgical follow-up compared to only 41% (n=36) of patients with documented gastroenterology follow-up within four-weeks of hospital discharge, P <0.05. Factors associated with more timely postoperative medical follow-up included younger age, longer length of hospitalization, postoperative biologic use and academic center patients. In the study cohort, 75.0% of patients resumed medical therapy within 12 mo, whereas only 53.4% of patients underwent a colonoscopy within 12 mo of surgery. CONCLUSION: Our study highlights the need for coordinated CD multidisciplinary clinics and structured handoffs among providers to improve of quality of care in the postoperative setting.

Original languageEnglish (US)
Pages (from-to)1182-1188
Number of pages7
JournalWorld Journal of Gastroenterology
Volume21
Issue number4
DOIs
Publication statusPublished - Jan 28 2015

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Keywords

  • Coordinated care
  • Crohn's disease
  • Multidisciplinary clinics
  • Postoperative prophylaxis
  • Surgery

ASJC Scopus subject areas

  • Gastroenterology

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