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snormal in this IBD cohort. BMI is a good predictor of FMI however correlated poorly withLMI. Clinical assessment of nutritional status using BMI alone would miss deficits in LMI andunder recognise iron deficiency. Iron deficiency is more common than hypoalbuminaemia inIBD patients and occurs despite normal Hb levels. Thus it is recommended that routineiron studies be included in the nutritional assessment of IBD patients.

Figure 1. BMI vs FMI z-score: Pearson correlation = 0.89 (95% CI 0.85, 0.92).

Figure 2. BMI vs. LMI z-score: Pearson correlation = 0.45 (95% CI 0.30, 0.57).

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Illness Perceptions and Coping Predict Quality of Life and Work Productivityin IBD Patients With Athropathy: A 12-Month Prospective StudyMike V. Have, Lianne Brakenhoff, Adrian A. Kaptein, Désirée van der Heijde, MargreetScharloo, Andrea E. van der Meulen - de Jong, Roeland Veenendaal, Daniel W. Hommes,Herma Fidder

Background: Arthropathies are the most common extraintestinal manifestation in patientswith inflammatory bowel disease (IBD). Although arthropathy impacts IBD patients' qualityof life (QOL), data regarding the impact of arthropathy on work productivity and predictorsfor these health outcomes are lacking. Aims: In a prospective cohort of IBD patients withand without arthropathy, the impact of joint pain, illness perceptions and coping on QOLand work productivity was determined. Methods: Our cohort included 245 IBD patients(72% Crohn's disease, 38% male, mean age 43 years). Arthropathy was assessed at baselineand defined as daily back pain for ≥ three months and/or peripheral joint pain and/or jointswelling during the last year. At baseline and at 12 months, patients completed questionnaireson joint pain (11-point Numeric Rating Scale), disease activity (Harvey Bradshaw Index andSimple Clinical Colitis Activity Index for Crohn's disease and ulcerative colitis, respectively),illness perceptions (Revised Illness Perception Questionnaire), coping (Coping with Rheu-matic Stressors), QOL (short IBDQ) and work productivity (Work Productivity ActivityImpairment, WPAI). Linear mixed models were performed to determine the impact of jointpain (step 1), illness perceptions (step 2) and coping (step 3) on QOL and work productivity,controlling for disease activity. Results: In total, 204 IBD patients (72% Crohn's disease,40% male, mean age 44 years) completed both baseline and follow-up questionnaire (lossto follow-up: 17%). No relevant differences were found between included patients andpatients lost to follow-up. Arthropathy was present in 113 (55%) patients: 8 (7%) with backpain, 41 (36%) with peripheral joint pain, 64 (57%) with mixed complaints. At both baselineand follow-up, IBD patients with arthropathy reported a lower QOL (p=0.000) and lowerwork productivity (p=0.000) compared to IBD patients without arthropathy. Linear mixedmodels (table) showed that a decrease in QOL was associated with joint pain (p<0.001),stronger beliefs that IBD will have negative consequences for one's life (illness consequences)(p<0.01), and negative beliefs about how IBD affects one's emotional well-being (p<0.001).Work productivity was associated with joint pain (p<0.001) and illness consequences. Thecoping strategy "decreasing activity to cope with pain" was associated with a decrease inQOL (p<0.05) but not with work productivity loss (p=0.09). Conclusions: Arthropathiesin IBD negatively impact the QOL and work productivity over extended periods of time.Illness perceptions and coping also had a significant impact on QOL and work productivity.As potentially modifiable factors, illness perceptions and coping may provide an additionaltarget for biopsychosocial interventions, aimed at improving QOL and increasing work pro-ductivity.Linear mixed models with quality of life (short IBDQ) and work productivity (WPAI) asoutcome variable and demographic/clinical variables (step 1), illness perceptions (step 2),and coping (step 3) as independent variables

S-602AGA Abstracts

* = p<0.05, ** = p<0.01, *** = p<0.001

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Cytomegalovirus Infection and Postoperative Complications in Patients WithUlcerative Colitis Undergoing ColectomyMaya Olaisen, Astrid Rydning, Tom C. Martinsen, Patricia G. Mjones, Ivar S. Nordrum,Reidar Fossmark

Background/aims: Cytomegalovirus (CMV) can reactivate and cause infection in the colonof patients with ulcerative colitis (UC). Reactivation may explain treatment resistance leadingto colectomy. We have examined the prevalence of CMV infection in UC patients undergoingcolectomy and identified risk factors for CMV as well as postoperative complications. Materialand methods: Seventy-seven consecutive patients with UC aged 16 years or older undergoingcolectomy because of active colitis were included in a retrospective analysis. Medical recordsand an institution based complication register were reviewed and patient characteristics,disease extension, disease duration and medical treatment before colectomy were registered.Duration of hospital stay, and complications up to 30 days postoperative were registeredand classified after Clavien classification. Immunohistochemistry for detection of CMV wasdone on sections from five different portions of the colectomy specimen. Results: Of the 77patients, 67.5% were men, 9% smokers and 26% previous smokers. Median preoperativedisease duration was 3 years (range 0.1-29). Mean daily dose of prednisolone at colectomywas 35±32 mg. Indication for the colectomy was fulminant colitis in 31% of the cases,whereas 48.1% of the surgeries were elective. ASA score was 1 or 2 in 75.3 % of the patientsand 24.7 % had ASA 3 or 4. Immunohistochemistry was performed on 73 patients, ofthese were 11 % (8/77) CMV+. The CMV+ patients received a significantly higher dosecorticosteroids at the time of colectomy than CMV- patients (59 mg/day vs. 34 mg/day, p=0.036). CMV+ patients had a higher rate of acute surgery and tended to have a higher ASAscore compared to CMV- patients (p=0.041 and p=0.078 respectively). There was no differ-ence in length of postoperative stay, CRP, high-dose steroid treatment between the CMV+and CMV- patients. Complications occurred in 39% of patients after surgery. Most complica-tions were grade 1 or 2, there were six grade 3 and no grade 4 complications. Two patients(2.6%) died in-hospital after the colectomy. Smokers had statistically more complicationsthan non-smokers. Patients with high ASA score (3 and 4) had significantly more seriouscomplications (grade 3-5). CMV+ patients did not have significantly more postoperativecomplications, however both patients dying after colectomy were CMV+. Current use orduration steroid treatment was not associated with higher complication rate or a longerpostoperative stay. Conclusions: A CMV+ colectomy specimen of patients with UC wasassociated with higher doses of corticosteroids at colectomy and higher rate of acute opera-tions. Smoking and high ASA score was associated with a higher risk of complications aftercolectomy. Dose or duration of steroid treatment was not associated with a higher riskof complications.

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Development and Validation of an Endoscopic Classification of DiverticularDisease of the Colon: Diverticular Inflammation and Complication Assessment(DICA)Antonio Tursi, Giovanni Brandimarte, Francesco Di Mario, Walter Elisei, Luigi Di Cesare,Piera Giuseppina Lecca, Michela Di Fonzo, Marcello Picchio, Giacomo Forti, RobertoFaggiani, Costantino Zampaletta, Antonio Penna, GianMarco Giorgetti

Background: Diverticular disease (DD) of the colon is frequently diagnoses by colonoscopy,but a validated endoscopic score is lacking at present. The aim of this study was to developa simple endoscopic score of DD, the Diverticular Inflammation and Complication Assessment(DICA) score. Methods: The DICA score for DD resulted in the sum of the scores forextension of diverticulosis (left and right colon), number of diverticula per district (up to15 and >15 diverticula per district), presence and type of inflammation (edema, hyperemiaand erosions), and presence and type of complications (rigidity of the colon, presence ofpus, stenosis, and bleeding): DICA 1 (up to 3 points); DICA 2 (score from 4 to 7 points);DICA 3 (over 7 points). For the development phase of the study, 70 consecutive patients,who underwent colonoscopy due to abdominal symptoms (abdominal pain, bleeding, consti-pation, diarrhea) and in whom a first diagnosis of diverticular disease was made, wereenrolled at 3 Gastroenterology Departments. Colonoscopy was recorded both at insertionand at withdrawal. Videos were visualized during plenary session and classified by endoscop-ists that did not know the DICA classification, and that were not involved in the construction