{
  "abstract": "Background Medical management of Crohn’s disease has evolved with biologics and newer agents. However, indications, timing, and type of surgery remain inadequately defined, especially in resource-constrained settings, with limited contemporary Indian data.Methods This retrospective study included 118 patients with Crohn’s disease managed at a tertiary care referral center (January 2018–February 2024). Demographic, clinical, biochemical, surgical, and postoperative data were collected. Statistical analysis was performed using IBM SPSS Statistics version 30 (SPSS). Ethical approval was obtained from the Institutional Ethics Committee (IEC) (IEC1-152-2024).Results A total of 118 patients were included (M: F = 80:38), with a mean disease duration of 24 ± 39.03 months. Baseline parameters are summarised ( IDDF2026-ABS-0376 Table 1). Most had ileocolonic involvement (L3), with stricturing (B2) and penetrating (B3) behavior. A total of 31 patients underwent surgery; indications included obstruction (41.9%), perianal disease (19.4%), and perforation (12.9%). Definitive procedures were performed in 45.2%, staged procedures in 29%, and stoma reversal in 25.8%.On multivariate analysis, steroid dependence (Odds ratio 5.19, p=0.041), higher C-reactive protein(CRP)/albumin ratio (OR 1.28, p=0.023), and granuloma (OR 4.09, p<0.001) predicted surgery (IDDF2026-ABS-0376 Table 2)Comparison of hospital stay is shown in Table 3 (IDDF2026-ABS-0376 Table 3). Among nonsurgical patients, longer hospital stay (>9 days) was associated with higher CRP/albumin ratio (15.64 vs 4.23, p=0.005), CRP (41.7 vs 16.35 mg/dL, p=0.029), and hospitalisations (3.5 vs 2, p=0.021). Albumin was lower but not significant (2.9 vs 3.3 g/dL, p=0.08), and strictures were comparable (40% vs 22.2%, p=0.58) (IDDF2026-ABS-0376 Table 3). Conclusions Preoperative CRP/albumin ratio, steroid dependence, and granuloma on biopsy predict surgery in Crohn’s disease. Elective resection for localised ileocecal/small bowel disease improves symptoms and reduces steroid use and hospitalisations. Damage-control surgery with a stoma in selected patients shows acceptable reversal rates.Abstract IDDF2026-ABS-0376 Table 1Clinical and biochemical parametersBMI (kg/m2, mean ± SD)19.8 ± 3.7CRP (mg/dL, median, range)25.9 (0.3–308)ESR (mm/hr, median, range)29.5 (2–120)Hemoglobin (g/dL, mean ± SD)10.6 ± 2.5Albumin (g/dL, mean ± SD)3.15 ± 0.88Platelets (×109/L, mean ± SD)361 ± 171CRP/Albumin (median, range)6.8 (0–167.6)CRP/Globulin (median, range)9.4 (0–99.4)Abstract IDDF2026-ABS-0376 Table 2Predictors of surgerySteroid dependence5.190.041CRP/albumin ratio1.280.023Granuloma on biopsy4.09<0.001Abstract IDDF2026-ABS-0376 Table 3Nonsurgical patients with short vs long hospital stayCRP/albumin ratio4.2315.640.005CRP (mg/L)16.3541.70.029Albumin (g/dL)3.32.90.08Hospitalizations23.50.021Stricture >10 cm2 (22.2%)2 (40%)0.58",
  "authors": [
    {
      "affiliations": [
        "Kasturba Medical College, Manipal, India"
      ],
      "name": "Anmol Malhotra"
    },
    {
      "affiliations": [
        "Kasturba Medical College, Manipal, India"
      ],
      "name": "Ganesh Bhat"
    },
    {
      "affiliations": [
        "Kasturba Medical College, Manipal, India"
      ],
      "name": "Bharat Bhat"
    }
  ],
  "title": "IDDF2026-ABS-0376 Who ends up in the or? unmasking predictors of surgery in crohn’s disease",
  "uid": "aac1e4a0-a383-5261-8939-f7a0d0f641e4"
}