P2122 - Characterizing the Perianal Fistulizing Phenotype of Penetrating Crohn's Disease - A Single-Center Experience

Debdeep Banerjee, MD¹, Dalton A. Norwood, MD², Mohamed S. Ismail, MD, MSc^3
1University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL; ²UAB Minority Health and Health Equity Research Center, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL; ³University of Alabama at Birmingham, Birmingham, AL

Introduction: Perianal fistulizing Crohn’s disease (CD) can drastically affect a patient’s quality of life with an overall prevalence of 1 out of every 4 patients with CD. Serum albumin levels are clinically thought to be an indicator of nutrition, and a predictor of outcomes in severe ulcerative colitis. We aimed to correlate serum albumin levels with outcomes in patients with perianal fistulizing CD.

Methods: We created a registry of patients with perianal fistulizing CD between 2011 to 2022. 77 patients were identified and a total of 55 patients were included in the study, after exclusion of those with idiopathic perianal fistulas or no documented diagnosis of concurrent CD. Patients’ demographics, clinical characteristics, and outcomes including hospitalizations, number and type of surgical intervention were collected. Regression analysis was performed to assess the association between various factors, including serum albumin levels and clinical outcomes.

Results: Hypoalbuminemia (< 3.7 gm/dL) was noted in 47% of patients with perianal CD. The majority of the patients underwent surgical intervention, including seton placement(s), fistulotomy, fistulectomy, diverting ostomy, or flap advancement. On univariable regression analysis, Black race and patients with hypoalbuminemia were at increased risk of hospitalization with odds ratio (OR) 3.23 [95% confidence interval (CI) 1.03 – 10.11, P = 0.044] and OR 11.73 [95% CI 3.04 – 45.27, P = < 0.001], respectively. On multivariable analysis, hypoalbuminemia was the only predictor of hospitalization in patients with perianal CD with OR 12.12 [95% CI 2.42 – 60.75, P = 0.002]. Patients with body mass index over 25 kg/m² but less than 30 kg/m² have lower risk of surgical intervention on univariable analysis with OR 0.07 [95% CI 0.01 – 0.62, P = 0.018] but not on multivariable analysis.

Discussion: Our study highlighted the increased risk of hospitalization in perianal CD patients with hypoalbuminemia. Further studies are needed to explore this finding in a larger sample size and assessing the impact of improving the nutritional status on outcomes in perianal CD patients.


Disclosures:


Debdeep Banerjee, MD¹, Dalton A. Norwood, MD², Mohamed S. Ismail, MD, MSc³. P2122 - Characterizing the Perianal Fistulizing Phenotype of Penetrating Crohn's Disease - A Single-Center Experience, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.