bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1241 Identification and characterization of patients with Crohn's disease and complex perianal fistulas using Natural Language Processing and machine learning: INTUITION-CPF Study.
Authors: García-Olmo D , Chaparro M , Marquez Mosquera L , González Argenté- F J , Perez Calle J L , Tomé Pizarro M , Aparicio J , Montoto C , Sánchez Guillén L , P Gisbert J 
Published: January 2025

Abstract

Background
Crohn’s disease (CD) is an inflammatory condition that can cause perianal fistulas (mostly complex), affecting 26-35% of CD patients. There is no gold-standard treatment for perianal disease, leading to significant unmet needs. This study uses Artificial Intelligence (AI) to analyze electronic medical records (EMRs) to identify and characterize CD patients with complex perianal fistulas (CPF). It offers an overview of patient characteristics, treatment patterns, and CPF incidence in CD patients attending inflammatory bowel disease units in Spain.

Methods
INTUITION-CPF is a national, multicenter, retrospective study. EMRs of patients with CD, diagnosed or not with CPF (overall CD population) from January 2015-December 2021, were reviewed and processed using an AI analysis based on machine learning and Natural Language Processing (NLP). There were two phases in the study. Phase 1: NLP-identified patients with CD+CPF were manually validated to assess sensitivity and specificity; and Phase 2: characteristics, treatments and visits to departments were analysed in eligible patients with CD+/-CPF. Here, we present results from the phase 2.

Results
A total of 2,182 patients with CD were identified. Median age (range) was 51 years (21-105). 263 patients (12%) suffered from CPF, of which 70% experienced pain, 48% active (suppurative) disease, and 28% perianal abscesses. The estimated annual incidence of CPF among CD patients was 1.6%.
Patients with CD+CPF had more medical treatments (91%) compared to overall CD patients (74%). Proportion of patients receiving biologics was near double for CD+CPF compared to overall CD patients (41% vs 21%) with infliximab the most frequently used (26%) (Table 1). 13% of the overall CD population had ≥1 surgery, compared with 36% of patients with CD+CPF. The main surgeries in patients with CD+CPF included seton placement (14%), advancement flap surgery (FLAP) (16%) and ostomy (13%) (Table 1).
Hospitalisation (≥24h) was required for 49% of overall CD patients vs 64% of those with CPF. Gastroenterology (73%) was the most frequently visited department, followed by surgery (31%) and emergency departments (27%) (Figure 1).

Conclusion
This study demonstrates that CD patients with CPF require more complex and multidisciplinary management, including more biological treatments and surgeries, and exhibit higher hospitalization and emergency visit rates compared to overall CD patients.Inconsistencies with the existing literature highlight the opportunity to further enhance NLP techniques to achieve more accurate outcomes.
P1243 Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study in Taiwan
Authors: Kuo T H , Tsai M J , Chou J W , Lai H C , Wu Y H , Huang P J , Cheng K S 
Published: January 2025

Abstract

Background
Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is rare in Taiwan. There are also few reports on the the prevalence rate of extraintestinal manifestations (EIMs) in IBD. This study aimed to assess the risk of EIMs in patients with IBD and examine the relationship between the timing of IBD diagnosis and EIM onset.

Methods
We conducted a retrospective cohort study using administrative data from the Taiwan National Health Insurance Research Database and Registry for Catastrophic Illness Patients Database from 2013 to 2021. The index date for the cohort was defined as the date of the first recorded IBD diagnosis. EIM diagnoses were identified in the health registry using the appropriate International Classification of Diseases 9 and 10 codes. The selection of EIMs refers to 2024 European Crohn's and Colitis Organisation (ECCO) guidelines, of which include uveitis, scleritis, episcleritis, Oral manifestations, PSC, AIH, spondyloarthropathy with axial/non-axial, pyoderma, gangrenosum, erythema nodosum, and Sweet syndrome1. We calculated the mean and median time of EIM onset relative to IBD and categorizing EIMs as occurring either before or after IBD onset.

Results
The study included 1,774 IBD patients. The incidence rate (IR) of EIMs in IBD patients was 1.167 per 100 persons/years from 2013 to 2021. The highest IR was 2.105 in 2013, and the lowest was 0.357 in 2021. The rate of EIMs development among IBD patients during the follow-up period from 2013 to 2019. Pyoderma had the highest IR at 0.846 per 100 persons/year, followed by primary sclerosing cholangitis at 0.733 per 100 persons/years, oral mucosa lesion at 0.733 per 100 people and ankylosing spondylitis at 0.564 per 100 persons/years (table1). Our analysis showed that EIMs appeared an average of 2.08 years after IBD diagnosis (median 1.48 years) and 5.50 years before IBD diagnosis (median 5.46 years).

Conclusion
We firstly reported the EIM risk by 1.167 per 100 persons/years in a relative low prevalence country. However, some classical EIMs mentioned in the 2024 ECCO guidelines do not occur as frequently among IBD patients in Taiwan as expected. We still need further investigation in this issue. We can extend the follow-up period to collect more data, which will allow us to reach a more solid and reliable conclusion.

References
1.Gordon H, Burisch J, Ellul P, et al. ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease. J Crohns Colitis. 2024;18:1-37. doi:10.1093/ecco-jcc/jjad108.
P1244 Differential impact of appendectomy with appendiceal inflammation versus no inflammation on inflammatory bowel disease risk in a population-based cohort
Authors: Agrawal M , Hansen A V , Harpaz N , Colombel J F , Jess T , Allin K H 
Published: January 2025

Abstract

Background
The appendix is implicated in inflammatory bowel disease (IBD) risk. However, the relationship of appendectomy for appendicitis versus other indications, when the appendix is not inflamed, with IBD onset is ambiguous. We conducted a population-based cohort study to explore the risk of ulcerative colitis (UC) and Crohn’s disease (CD) following appendectomy of the inflamed appendix and removal of the uninflamed appendix for other indications.

Methods
We conducted a matched cohort study where all individuals with appendectomy in the Danish National Patient Register between January 1997 and August 2022 were matched 1:10 by sex, year of birth and municipality of residence at the time of appendectomy to individuals without appendectomy. Study participants were excluded if they were not residents of Denmark for at least two years prior to the index date. Based on cross-linked data from the Danish Pathology Register, we categorized appendectomy cases into those with and without appendiceal inflammation. Follow up started 180 days after appendectomy until IBD diagnosis, based on primary and secondary diagnoses codes in the National Patient Register, emigration, death or end of the study period, whichever came first. We used Cox proportional hazards regression to calculate the hazard ratios and 95% confidence interval for outcomes UC and CD, in appendectomy cases with and without appendiceal inflammation, compared to individuals without appendectomy after adjusting for age at appendectomy (index date), sex, calendar year, urbanization, and municipal-level socioeconomic index.

Results
A total of 145,147 individuals who underwent appendectomy and 1,451,470 individuals without appendectomy were followed for a median of 12 (IQR 6,19) years. Of all individuals with appendiceal inflammation, no appendiceal inflammation, and individuals without appendectomy, 308, 149 and 6,052 were diagnosed with UC, and 336, 191 and 3,166 with CD, respectively, during follow up. Kaplan Meier curves are demonstrated in the Figure. The adjusted hazard ratio (95% CI) for UC among those with and without appendiceal inflammation, compared to individuals without appendectomy, was 0.65 (0.58 - 0.73) and 1.26 (1.06 - 1.50), respectively. Corresponding estimates for CD were 1.33 (1.19 - 1.50) and 3.13 (2.65 - 3.69), respectively.

Conclusion
In a nationwide cohort with long-term follow up data, appendectomy following appendiceal inflammation was protective against UC while appendectomy following no inflammation was associated with increase in UC risk. Appendectomy, irrespective of appendiceal inflammation, was associated with CD risk.
P1245 Maternal intake of fish, dietary n-3 polyunsaturated fatty acids, and fish oil supplements during pregnancy and risk of early childhood Inflammatory Bowel Disease in the offspring
Authors: Brusco De Freitas M , Anneberg O M , Frodi Olsen S , Vinkel Hansen A , Ahrendt Bjerregaard A , Ingi Halldórsson Þ , Jess T 
Published: January 2025

Abstract

Background
A key question remains unanswered: whether maternal consumption of fish and fish oil supplements during pregnancy is associated with the risk of early childhood inflammatory bowel disease (IBD) in offspring. This association was examined in the present study.

Methods
Data from the Danish National Birth Cohort (1996–2002) were used, which collected maternal dietary data in early pregnancy using a food frequency questionnaire (FFQ), and data from the National Patient Registry to identify IBD cases. The study included mother-child dyads in which the mother had a singleton pregnancy, responded to the FFQ and demonstrated plausible energy intake and children under the age of 18 were considered. The exposure variables were assessed as tertiles of maternal intake of total fish (g/day), oily fish (g/day), lean fish (g/day), n-3 polyunsaturated fatty acids (PUFA) (g/day) from diet, and fish oil supplements (yes/no). Cox regression was used to calculate the hazard ratio (HR) with 95% confidence intervals (CIs) with the first tertile [T (lower intakes)] as the reference. Analyses were adjusted for maternal educational level, gestational weight gain, alcohol intake, smoking, antibiotics, parental IBD, diet quality (Healthy Eating Index), and offspring antibiotic consumption.

Results
The study included data on 67,770 mother-child dyads, and, among the offspring, 192 cases of IBD [Crohn disease (CD), n= 106; ulcerative colitis (UC), n= 86] were identified. The mean intake (standard deviation [SD]) in g/d was 27.2 (±6.10) of fish, 14.7 (±3.79) of oily fish and 12.5 (±3.34) of lean fish. The mean (SD) intake of n-3 PUFA was 0.509 g/d (±0.40), and 5.9% of women consumed fish oil during pregnancy. High maternal intake (T3) of n-3 PUFA was associated with a 38% reduction in IBD risk (HR: 0.62, 95% CI: 0.38-0.98) in offspring, whereas average intake of oily fish reduced the risk of UC in offspring (p= 0.047). Average (T2) and high intakes of lean fish also reduced the risk of IBD, by 49% (HR: 0.51, 95% CI: 0.33-0.77) and 35% (HR: 0.65, 95% CI: 0.43-0.98), respectively. More specifically, an average intake of lean fish reduced offspring CD risk by 58% (HR: 0.42, 95% CI: 0.23-0.77). No association was found in relation to the other variables.

Conclusion
The type of fish consumed during pregnancy appeared to influence the risk of developing CD and UC differently. Our large-scale population study suggests that maternal consumption of oily fish is protective against the development of UC in offspring, while maternal consumption of lean fish is protective against development of CD in offspring. Overall, these results favor fish consumption in pregnancy.
P1248 Higher Life’s Essential 8 score is associated with reduced risk of IBD-related surgery and all-cause mortality among 3,232 individuals with inflammatory bowel disease in a prospective cohort study
Authors: Jing F , Cao Y , Gong Q , Dan L , Zhu Y , Magro F , Fu T , Wang X , Chen J 
Published: January 2025

Abstract

Background
Previous studies indicated lifestyles that benefit cardiovascular health, are associated with the risk of prognosis in inflammatory bowel disease (IBD), while evidence lacked regarding the impact of cardiovascular health as a whole. We aimed to explore the potential longitudinal association between the overall cardiovascular health indicator, Life’s Essential 8 (LE8), and the adverse outcomes of IBD.

Methods
Using data from the UK Biobank, we included 3,232 individuals with IBD recruited in 2006–2010. The components of LE8, including diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure, were measured and given a score of 0–100. The LE8 score for each individual was the mean score of all components and was divided into three levels: low (0–49), moderate (50–79), and high (80–100). The adverse outcomes studies in our study included IBD-related surgery and all-cause mortality, ascertained via primary care, hospital inpatient data, and death registry. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the magnitude of the associations.

Results
Among the 3,232 individuals with IBD, 1,579 were female (49%) and 2,227 were with UC (69%). Over a mean (standard deviation) follow-up of 12.60 (2.74) years and 13.17 (1.89) years, 282 IBD-related surgery and 259 death events were documented. Among participants with UC, compared to participants with low LE8 score, the HRs (95% CIs) of those with high score for IBD-related surgery and all-cause mortality were 0.47 (0.26, 0.87) and 0.47 (0.25, 0.87). Similar inverse associations were demonstrated from the competing risk model between LE8 score and IBD-related surgery among individuals with UC. In addition, we did not observe any significant associations of LE8 score with the risk of IBD-related surgery and all-cause mortality among CD. The above associations were robust in sensitivity analyses when further adjusted for aminosalicylate use, corticosteroid use, immunomodulator use, CRP concentration, or baseline IBD duration separately.

Conclusion
Conclusion: Participants with higher LE8 score showed decreased risk of IBD-related surgery and all-cause mortality among individuals with UC, but not CD, highlighting the important role of adopting LE8 in improving the prognosis of UC. Future randomized control studies are needed to confirm the effect of enhancing LE8 score to reduce the risk of IBD-related surgery and all-cause mortality and better manage the disease course of IBD.
P1250 Spondyloarthritis before and after inflammatory bowel disease diagnosis and risk factors: a temporal trends analysis in a population-based cohort
Authors: Agrawal M , Sorensen C , Poulsen G , Moghaddam B , Gulko P S , Colombel J F , Jess T 
Published: January 2025

Abstract

Background
Axial and peripheral spondyloarthritides (SpA) and inflammatory bowel disease (IBD) are immune-mediated diseases with overlap in clinical and immunological features. However, temporal correlation of SpA and IBD in individual patients is not well characterized.

Methods
We conducted a nationwide population-based study between January 1, 1998 and July 31, 2022 to determine SpA prevalence before, and incidence after IBD diagnosis. Using ICD-10 codes in cross-linked Danish registers, we identified all residents with IBD diagnosis between January 1, 2006 and July 31, 2014 as well as controls matched 1:5 on age, sex, calendar year, and municipality of residency. We determined the odds ratios of SpA in the IBD group in the preceding years. Using adjusted Cox regression analysis, we determined the hazard ratios of new-onset SpA following IBD diagnosis in the proceeding years.

Results
Of 111,696 individuals included in the study, 18,616 (16.7%) were diagnosed with IBD. The prevalence of SpA was higher in IBD cases relative to matched controls (Figure). The aOR of SpA among those who later developed IBD, UC, or CD, compared to matched controls, was 1.98 (95% CI 1.81, 2.17), 1.67 (95% CI 1.49, 1.87) and 2.76 (95% CI 2.37, 3.21), respectively, in the 8-year period preceding IBD diagnosis. The odds of SpA were highest in the 2 years preceding IBD diagnosis. Among those with IBD, UC, and CD, compared to those without IBD, the aHR of new-onset SpA was 2.47 (95% CI 2.30, 2.65), 2.18 (2.00, 2.37), and 3.20 (95% CI 2.84, 3.60), respectively. When stratifying the IBD effect of SpA on sex and age, both females and the age group 8-45 years had higher risks for SpA following IBD diagnosis, when compared to male and older age groups, respectively.

Conclusion
In a population-based cohort, we demonstrate that the odds of SpA diagnosis are increased at least up to 8 years preceding IBD diagnosis and are highest 2 years preceding IBD diagnosis. SpA risk is increased among those with IBD, particularly among women and young adults. These clinical associations can improve early diagnosis and treatment of both IBD and SpA.
P1252 Prevalence, Incidence and Mortality of Pediatric Inflammatory Bowel Disease in Catalonia
Authors: Brunet E , Loverdos I , Vela E , Comalrena de Sobregrau C , Garcia-Tirado D , Melcarne L , Pontes C , Llovet L P , Garcia-Sague B , Frisancho L E , Lario S , Puy A , Ramirez-Lazaro M J , Villoria A , Calvet X 
Published: January 2025

Abstract

Background: Introduction
The epidemiologic status of pediatric inflammatory bowel disease (PIBD) has not been widely studied in Western Europe. The prevalence and incidence trends of the disease are largely unknown. The aim of this study is to determine the prevalence and incidence of PIBD and its mortality rate in Catalonia in the period 2011-2023.

Methods: Material and methods
A longitudinal study was performed using population-based data from the Catalan Health Surveillance System (CHSS). Data on prevalence, incidence and mortality of IBD in patients under the age of 18 years were obtained. Trends in age- and sex-adjusted rates were estimated. Crohn's disease (CD) and ulcerative colitis (UC) were also analysed separately.

Results
The number of PIBD patients rose from 307 in 2011 to 725 in 2023, with increases of 173% in UC and 113% in CD. The age- and sex-adjusted prevalence of PIBD rose from 23 (95%CI 20.5-25.7) to 48.1 (95%CI 44.7-51.7) per 1,000,000 inhabitants, while the annual incidence doubled, from 81 to 168. Although the peak incidence was recorded in 2022, the data suggest a flattening of the incidence curve in recent years. Seven patients died during follow-up, although the mortality rates were too low for further analysis.

Conclusion
Conclusion: The prevalence of PIBD is increasing rapidly in Catalonia. We observed also a trend towards a plateauing in the incidence that may suggest that prevalence might stabilize in the coming years.

References
N/A
P1255 Impact of depression on health related quality of life in Ulcerative Colitis patients-are we doing enough? A single tertiary center experience
Authors: Jaksic D , Vuksanovic S , Toplicanin A , Spiric--Milovancevic J , Maric G , Sokic-Milutinovic A 
Published: January 2025

Abstract

Background
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that significantly impacts patient’s health-related quality of life (HRQOL). Psychological factors such as anxiety, depression, and alexithymia may exacerbate these effects. This study aims to evaluate: HRQOL and possible factors affecting it, prevalence of anxiety, depression and alexytimia in patients with UC.

Methods
A cross-sectional study included 248 UC patients (117 males, mean age 44,7±14,6, 21 with proctitis, 63 with left sided and 164 with extensive colitis) Data were collected using standardized self-administered questionnaires (socio-demographic, GAD-7, PHQ-9, TAS-20 and SIBDQ-10). Clinical data on remission status, extraintestinal manifestations (EIM), comorbidities and use of advanced therapies were also collected. Hierarchical regression analysis of variables predicting SIBDQ-10 score in UC was done.

Results
In our patients average disease duration was 9.3 ± 7.4 years (range 0-49). 198 patients (79.8%) were treated with advanced therapies. Clinical and laboratory remission was present in 237 (95.6%) patients. Prevalence of depression, anxiety and alexithymia were 44.7%, 34.3% and 30.2% respectively. There were no differences in PHQ-9, GAD-7 and TAS-20 scores in relation to remission status (p&gt;0.05). Average SIBDQ score was 56.5 ± 10.9. Patients in remission reported better SIBDQ-10 compared to those experiencing active symptoms (p=0.002). Results of hierarchical regresion analysis showed that remission of disease and higher depression score are the main factors influencing HRQOL in UC patients.

Conclusion
Prevalence of depression, anxiety and alexithymia in UC patients is high, even if disease is in remission. Remission of disease and high depression score are the main factors related to HRQOL. Depression adversely affects HRQOL in UC patients, highlighting the need for psychological screening and integrated mental health support in all UC patients. Strategies aimed at enhancing emotional well-being may improve overall quality of life and disease management in UC.
P1261 Reproductive Health Outcomes in Colombian Women with Inflammatory Bowel Disease: A Multicenter Cohort Study on Pregnancy, Fertility, and Disease Impact (REINFORCE Study)
Authors: Parra Izquierdo V , Osorio-Castrillon L , Juliao-Baños F , Frías-Ordoñez J 
Published: January 2025

Abstract

Background
The impact of Inflammatory Bowel Disease (IBD) on women's health, particularly in relation to reproductive health, remains an underexplored area in Latin American populations. This study aims to assess the effects of IBD on women's reproductive health, including pregnancy outcomes, fertility, and related complications, within a cohort of Colombian women.

Methods
Observational, multicenter and descriptive study involving adult and pediatric patients from two IBD Centers in different cities in Colombia. The study focused on evaluating aspects of sexual and reproductive health in women with IBD, with detailed data collection on pregnancy, fertility, childbirth, and cancer screening.

Results
Out of a total of 121 women with IBD, 63.6% (77/121 patients) were in reproductive age (15–44 years according to World Health Organization) (Table 1), the mean age was 33.2 years (range: 17.2–44.8 years, SD: 8), with a mean age at diagnosis of 28 years (range: 9.3–45.1 years, SD: 8.8) and a disease duration of 5.2 years (range: 0.3–21.9 years, SD: 4.7). UC was more prevalent in this group (71.4%). Most women had low rates of smoking, hospitalization, and surgical interventions for IBD, and pregnancy-related complications were generally rare. The majority of births were vaginal deliveries, and breastfeeding beyond 6 months was common, suggesting protective effects against IBD risk in offspring. Notably, while HPV vaccination rates were low, the prevalence of cervical cancer was also low. Family planning was reported by 48% of participants, and 1% required assisted reproductive technologies. Statistical analysis showed no significant association between age and pregnancy complications across age groups. However, UC was significantly associated with a higher risk of pregnancy complications (OR 5.5; 95% CI: 1.9–14.9; p=0.0001), and Crohn's disease (CD) also showed a trend toward increased risk (OR 4.6; 95% CI : 0.2–20.4; p=0.00002). Previous history of hospitalization due to disease activity, surgery, and the use of biological therapy was associated with an increased risk of pregnancy complications when it occurred (OR 1.97; 95% CI: 1.6–2.5; p= 0.07 for hospitalization, OR 12.12; 95% CI: 4.2–27.8; p=0.03 for surgery, OR 5.2; 95% CI: 1.64-13.1 ;p=0.00001).

Conclusion
This study underscores the significant impact of IBD on reproductive health in Colombian women, similar to trends in other populations. It emphasizes the importance of effective disease management before conception, given that the use of biological therapies that usually are associated with more severe disease, ongoing disease activity, and prior surgical interventions are risk factors for increased pregnancy complications.