Evaluation of association between precolectomy thrombocytosis and the occurrence of inflammatory pouch disorders

Lei Lian, Victor W Fazio, Ian C Lavery, Jeff Hammel, Feza H Remzi, Bo Shen
Diseases of the Colon and Rectum 2009, 52 (11): 1912-8

BACKGROUND: There are inconsistencies regarding the risk factors associated with pouchitis and Crohn's disease of the pouch after ileal pouch-anal anastomosis. The aim of this study was to evaluate the associations between precolectomy routine laboratory tests, including platelet counts, and occurrences of inflammatory pouch disorders.

METHODS: All eligible patients were included from The Pouchitis Clinic. All patients undergoing ileal pouch-anal anastomosis for ulcerative colitis were included if their preoperative laboratory tests were available. Demographic, clinical, endoscopic, and laboratory tests were evaluated with univariate and multivariate analyses.

RESULTS: A total of 251 patients were included. Fifty-five patients had acute pouchitis and 29 had chronic pouchitis. Forty-two patients were diagnosed with Crohn's disease of the pouch. In multivariate analysis, elevated platelet count was not associated with chronic pouchitis (odds ratio, 0.91; 95% confidence interval, 0.32-2.59; P = 0.86) or Crohn's disease of the pouch (odds ratio, 0.87; 95% confidence interval, 0.38-1.97, P = 0.73) after adjusting for gender, smoking, extraintestinal manifestations, and pouch duration. Active smoking was associated with Crohn's disease of the pouch (odds ratio, 5.64; 95% confidence interval, 1.98-16.1; P = 0.001). No other laboratory tests, including white blood cell counts, albumin levels, and hemoglobin levels, were associated with the pouch outcomes. The presence of extraintestinal manifestations was associated with acute pouchitis (odds ratio, 1.89; 95% confidence interval, 0.95-1.14; P = 0.05) and chronic pouchitis (odds ratio, 2.6; 95% confidence interval, 1.13-5.87; P = 0.03).

CONCLUSION: Precolectomy laboratory tests, including platelet counts, did not appear to impact the occurrence of inflammatory pouch disorders after ileal pouch-anal anastomosis.


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