BACKGROUND Although there are discrepancies in the development and progression of inflammatory bowel disease based on biologic sex, little is known about differences in postoperative outcomes between men and women undergoing surgery for this condition. OBJECTIVE Our objective was to compare rates of anastomotic leaks, wound complications, and serious adverse events between men and women undergoing surgery for inflammatory bowel disease. DESIGN This was a retrospective cohort study. SETTINGS Data were obtained from the American College of Surgeons National Surgical Quality Improvement Program Inflammatory Bowel Disease Collaborative database, which includes 15 high-volume inflammatory bowel disease surgery centers. PATIENTS All adult patients undergoing surgery for inflammatory bowel disease were included. Subjects with missing data for exposure or outcome variables were excluded. MAIN OUTCOME MEASURES Rates of anastomotic leaks, wound complications, and serious adverse events were compared between women and men. RESULTS A total of 3143 patients were included. There was a significant association between sex and body mass index, inflammatory bowel disease type, and preoperative medication use. Women had decreased odds of serious adverse events compared to men (OR=0.73, 95% CI: 0.55-0.96), but there was no significant association between sex and anastomotic leaks or wound complications. Inflammatory bowel disease type was found to be an effect measure modifier of the relationship between sex and serious adverse events. Among ulcerative colitis patients, women had a 54% decrease in the odds of serious adverse events compared to men, while there was no significant difference between women and men with Crohn's disease. LIMITATIONS This study was limited by capturing only 30 days of postoperative outcomes. CONCLUSIONS Women undergoing surgery for ulcerative colitis had decreased odds of serious adverse events compared to men. Understanding sex-based differences in outcomes allows clinicians to make patient-centered decisions regarding surgical planning and perioperative management for inflammatory bowel disease patients..

中文翻译：

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炎症性肠病手术结果的性别差异。

背景虽然根据生物学性别，炎症性肠病的发生和进展存在差异，但对于接受这种疾病手术的男性和女性术后结果的差异知之甚少。目的 我们的目的是比较接受炎症性肠病手术的男性和女性之间的吻合口瘘、伤口并发症和严重不良事件的发生率。设计 这是一项回顾性队列研究。设置 数据来自美国外科医生学会国家手术质量改进计划炎症性肠病协作数据库，其中包括 15 个大容量炎症性肠病手术中心。患者所有接受炎症性肠病手术的成年患者均包括在内。暴露或结果变量数据缺失的受试者被排除在外。主要观察指标比较女性和男性的吻合口瘘、伤口并发症和严重不良事件的发生率。结果 共纳入 3143 名患者。性别与体重指数、炎症性肠病类型和术前药物使用之间存在显着相关性。与男性相比，女性发生严重不良事件的几率较低（OR=0.73，95% CI：0.55-0.96），但性别与吻合口瘘或伤口并发症之间没有显着关联。研究发现，炎症性肠病类型是性别与严重不良事件之间关系的效应测量修正因素。在溃疡性结肠炎患者中，女性发生严重不良事件的几率比男性低 54%，而患有克罗恩病的女性和男性之间没有显着差异。局限性 本研究的局限性在于仅记录了 30 天的术后结果。结论 与男性相比，接受溃疡性结肠炎手术的女性发生严重不良事件的几率较低。了解基于性别的结果差异使临床医生能够就炎症性肠病患者的手术计划和围手术期管理做出以患者为中心的决策。