Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK Biobank

Abstract Although corticosteroids are an important treatment for inflammatory bowel disease (IBD) patients, many subjects develop dependence, leading to serious long-term side effects. We applied causal inference analyses to investigate the length of steroid use on reoperations in IBD patients. We i...

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Main Authors: Uri Kartoun, Akira Koseki, Akihiro Kosugi, Kingsley Njoku, Tesfaye Yadete, Eileen Koski, Joao Bettencourt-Silva, Natasha Mulligan, Jianying Hu, Julia Liu, Thaddeus Stappenbeck, Vibha Anand
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Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-75215-5
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author Uri Kartoun
Akira Koseki
Akihiro Kosugi
Kingsley Njoku
Tesfaye Yadete
Eileen Koski
Joao Bettencourt-Silva
Natasha Mulligan
Jianying Hu
Julia Liu
Thaddeus Stappenbeck
Vibha Anand
author_facet Uri Kartoun
Akira Koseki
Akihiro Kosugi
Kingsley Njoku
Tesfaye Yadete
Eileen Koski
Joao Bettencourt-Silva
Natasha Mulligan
Jianying Hu
Julia Liu
Thaddeus Stappenbeck
Vibha Anand
author_sort Uri Kartoun
collection DOAJ
description Abstract Although corticosteroids are an important treatment for inflammatory bowel disease (IBD) patients, many subjects develop dependence, leading to serious long-term side effects. We applied causal inference analyses to investigate the length of steroid use on reoperations in IBD patients. We identified subjects in the UK Biobank general practice dataset with at least one major GI surgery and followed them for at least 5 years to evaluate subsequent operations. We defined steroid dependence as at least 12 weeks of use (vs. acute steroid use) prior to baseline surgery. Of the 363 subjects included in our analyses, 163 (45%) were prescribed steroids on or before baseline surgery, and of these (N = 125 of 163, 77%) were dependent. Additional analyses for time-dependent data on prescriptions found a link between prescription length and reoperation. Among UC subjects with acute use, the odds of reoperation were significantly lower (OR: 0.32, 95% CI: 0.0–0.73). Steroid dependence resulted in a delay of reoperation (median 1.2 vs. 2.3 years, P = 0.01). Our findings indicate that long-term steroid use tends to increase the need for reoperation, whereas short-term use may reduce it.
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spelling doaj-art-a33f0c9dbd314e5ea1775ede17b3e4a02024-12-01T12:22:20ZengNature PortfolioScientific Reports2045-23222024-11-0114111210.1038/s41598-024-75215-5Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK BiobankUri Kartoun0Akira Koseki1Akihiro Kosugi2Kingsley Njoku3Tesfaye Yadete4Eileen Koski5Joao Bettencourt-Silva6Natasha Mulligan7Jianying Hu8Julia Liu9Thaddeus Stappenbeck10Vibha Anand11IBM ResearchIBM ResearchIBM ResearchDepartment of Internal Medicine, Morehouse School of MedicineDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland ClinicIBM T.J. Watson Research CenterIBM Research EuropeIBM Research EuropeIBM T.J. Watson Research CenterDepartment of Internal Medicine, Morehouse School of MedicineDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland ClinicIBM ResearchAbstract Although corticosteroids are an important treatment for inflammatory bowel disease (IBD) patients, many subjects develop dependence, leading to serious long-term side effects. We applied causal inference analyses to investigate the length of steroid use on reoperations in IBD patients. We identified subjects in the UK Biobank general practice dataset with at least one major GI surgery and followed them for at least 5 years to evaluate subsequent operations. We defined steroid dependence as at least 12 weeks of use (vs. acute steroid use) prior to baseline surgery. Of the 363 subjects included in our analyses, 163 (45%) were prescribed steroids on or before baseline surgery, and of these (N = 125 of 163, 77%) were dependent. Additional analyses for time-dependent data on prescriptions found a link between prescription length and reoperation. Among UC subjects with acute use, the odds of reoperation were significantly lower (OR: 0.32, 95% CI: 0.0–0.73). Steroid dependence resulted in a delay of reoperation (median 1.2 vs. 2.3 years, P = 0.01). Our findings indicate that long-term steroid use tends to increase the need for reoperation, whereas short-term use may reduce it.https://doi.org/10.1038/s41598-024-75215-5SteroidsInflammatory bowel diseaseCausal inferenceRisk predictionPrescription patterns
spellingShingle Uri Kartoun
Akira Koseki
Akihiro Kosugi
Kingsley Njoku
Tesfaye Yadete
Eileen Koski
Joao Bettencourt-Silva
Natasha Mulligan
Jianying Hu
Julia Liu
Thaddeus Stappenbeck
Vibha Anand
Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK Biobank
Scientific Reports
Steroids
Inflammatory bowel disease
Causal inference
Risk prediction
Prescription patterns
title Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK Biobank
title_full Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK Biobank
title_fullStr Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK Biobank
title_full_unstemmed Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK Biobank
title_short Investigating the impact of steroid dependence on gastrointestinal surgical outcomes from UK Biobank
title_sort investigating the impact of steroid dependence on gastrointestinal surgical outcomes from uk biobank
topic Steroids
Inflammatory bowel disease
Causal inference
Risk prediction
Prescription patterns
url https://doi.org/10.1038/s41598-024-75215-5
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