Appau 2008.
Study characteristics | ||
Methods | Retrospective cohort. Study period: 1998 to 2007. | |
Participants | Country: USA. CD patients who underwent ileocolonic resection with anastomosis. | |
Interventions | 1. Preoperative infliximab (n= 60) within 3 months of surgery 2. No preoperative infliximab (n=329) |
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Outcomes | Wound infection, wound complications, anastomotic leak, sepsis and intraabdominal abscess within 30 days of surgery | |
Notes | NOS low risk of bias overall A djusted OR s for infliximab, 6MP/azathioprine/ methotrexate, and steroids were obtained from multivariate logistic regression model. |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Representativeness of the exposed cohort | Low risk | CD database of all patients who underwent ileocolonic resection at the Cleveland Clinic |
Selection of the non exposed cohort | Low risk | Both groups obtained from the same hospital and time period |
Ascertainment of exposure | Low risk | Medication use verified with pharmacy department and patients were called to confirm last dose of infliximab infusion |
Demonstration that outcome of interest was not present at start of study | High risk | Some patient were noted to have intraabdominal abscesses preoperatively |
Comparability of cohorts (Controlled for critical factor/other medications) | Low risk | Adjusted for methotrexate, 6‐mercaptopurine, azathioprine, infliximab and steroid use |
Comparability of cohorts (Controlled for additional factor) | Low risk | Also adjusted for age, gender, comorbidities, penetrating abscess before surgery, diverting stoma, and disease phenotype |
Assessment of outcome | Low risk | Medical charts were reviewed |
Was follow‐up long enough for outcomes to occur | Low risk | 30 days |
Adequacy of follow up of cohorts | Unclear risk | No information was provided |