Nader Daoud, MD, Jana Hashash, MD, MSc, Michael Picco, MD, PhD, Francis A. Farraye, MD, MSc Mayo Clinic, Jacksonville, FL
Introduction: Background: Severe Crohn’s disease (CD) can result in extensive bowel resections and creation of an ileostomy. Fecal calprotectin (FC) is well studied in CD management yet its role after surgical resection in patients who have an ileostomy is unclear. Our aim is to understand if FC is a useful adjunct to radiographic or endoscopic studies in identifying recurrent CD after surgery amongst ileostomy patients.
Methods: Methods: Between 1/1/2017 and 09/30/2020, we searched the Mayo Clinic electronic medical record retrospectively for adult patients with ICD-10 code for CD, and a surgical history of an ileostomy. Patients were included in the analysis if they had at least one FC measured and a concomitant radiographic imaging and/or endoscopic procedure. Abnormal FC was defined as greater than 60 mcg/g.
Results: Results: Fifty one patients met our inclusion criteria. Of the 51 patients, 17 had a FC level above 60. Of these 17 patients, 14 had imaging, an ileoscopy or both confirming the presence of small bowel inflammation with a sensitivity of 87.5%. Of the remaining 34 patients with a FC level of 60 or less, 32 patients had imaging, an ileoscopy or both demonstrating no small bowel inflammation with a specificity of 91.4%. A receiver operating characteristic (ROC) curve, demonstrated in Figure 1, plotted all FC cutoffs and their sensitivities versus 1-specificity. A FC of greater than 60 has a positive predictive value of 82.3%, a negative predictive value of 94.1% and test diagnostic accuracy of 90.1%. Table 1 summarizes our results.
Discussion: Conclusion: FC from an ileostomy output is a highly sensitive and specific test for the assessment and monitoring of small bowel inflammation and disease recurrence in patients with CD.
Table: Table 1 – Fecal calprotectin test results analysis
Disclosures: Nader Daoud indicated no relevant financial relationships. Jana Hashash indicated no relevant financial relationships. Michael Picco indicated no relevant financial relationships. Francis Farraye indicated no relevant financial relationships.
Nader Daoud, MD, Jana Hashash, MD, MSc, Michael Picco, MD, PhD, Francis A. Farraye, MD, MSc. P2672 - Fecal Calprotectin From Ileostomy Output Is Sensitive and Specific for the Prediction of Small Bowel Inflammation in Patients With Crohn's Disease, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.