use and disease characteristics was obtained. Fisher's exact test and paired T-test were usedfor statistical analysis. Results In total 348 patients participated. In group 1, 300 CD ptswere included, 192 females (64%); mean age 40 years (range 17-75); mean duration of thedisease 12 years (range 0-55). The mean CIS score was 39 (range 8-56). Overall, 68% ofthe patients (204 pts) experienced fatigue. More females (142 pts, 74.3%) than males (62pts, 57.4%, p=0.005) demonstrated fatigue. Patients with fatigue had significantly moreclinical depression (51 pts, 25%; 2 pts, 2.1% of non-fatigue patients, p=0.0001) and anxiety(62 pts, 7 pts, 7.3% of non-fatigue patients, p=0.0001). Active disease was found in a higherpercentage of fatigue patients than non-fatigue patients (53.4%; 16.7% respectively, p=0.0001). Medical therapy and previous CD surgery did not influence the fatigue score.Group 2 included 48 CD pts, 33 females (69%); mean age 45 years (range 26-72); meanduration of the disease 16 years (range 2-40). The mean CIS score was 36 (range 8-56).Overall, 64.6% of the patients (31 pts) experienced fatigue. Comparing group 1 and 2showed no significant differences. Conclusions: Patients with CD have a high prevalence offatigue. The fatigue affects significantly more females, patients with active disease and patientswith anxiety and depression. The sequence of the questionnaires has no impact on thedifferent scores.

T1331

Physical Fatigue and Muscle Strength in Patients With Crohn DiseaseSandro Dorf, Carmen Lucia N. de Castro, Daniela B. Rodeiro, Celeste C. Elia, ValdisneaA. Santos, Cyrla Zaltman

Fatigue is a frequent symptom in patients with Crohn Disease (CD), even in periods ofdisease remission, affecting their quality of life. It has a multifactorial etiology, and can beassociated with the reduction of peripheral muscular strength. Aims: Estimate the prevalenceof fatigue in a group of CD patients considering the possible influence of peripheral muscularstrength. Methods: 61 patients diagnosed with CD through clinical, laboratorial, radiological,endoscopic and histopathological criteria, both genders, ages between 18 - 60yrs that arefollowed in specialized outpatient unit of the hospital from the Federal University of Riode Janeiro (HUCFF-UFRJ), from 07/ 2008 to 05/ 2009 were included. Exclusion Criteria:extensive intestinal resection, all possibly comorbidity resulting in additional fatigue andlower limbs musculoskeletal pain. Disease activity was evaluated by CDAI. The patientswere in use of 5 ASA derivates, steroids or immunomodulators. Self-reported fatigue wasmeasured by the Chalder Fatigue Scale ( CFS) and an Visual Analogue Scale (VAS). Peripheralmuscular strength was measured by the maximum isometric handgrip strength (HS) andquadriceps strength (QS) using the JAMAR hydraulic (HS) and the Kroman-Thrigger IsoTestelectromechanic dinamometers(QS). Statistical analysis was done with SPSS program version11.0, applying the Pearson and Spearman Correlation for parametric and non-parametricvariables, respectively. Significance level was considered p < 0,05. Results: Fatigue (CFS)occurred in 62,3% of the cases (44,7% women; 55,3% men; p= 0,249), being the majorityin remission ( 52,6 % vs 47,4%; p= 0,057). Deficit of QS and HS were detected in 71%and 30 % of male and 47,6% and 45,2% of female patients , respectively. There were verifieda positive association between both fatigue scores (CFS vs VAS r=0,762;p<0,01), a negativeassociation between fatigue scores and CDAI (VAS vs CDAI r=-0,451,p<0,01; CFS vs CDAIr=-0,402;p<0,002) or HS ( VAS vs HS r=-0,347,p=0,007; CFS vs HS r=-0,288;p=0,025).There was no association between the fatigue scores, the QS or the disease duration. Conclu-sion: There was high prevalence of fatigue and isometric muscle strength deficit in CD,regardless of the gender. Further studies are necessary to verify if others parameters ofmuscle function as resistance tolerance can be related to fatigue in CD patients.

T1332

Clinical Presentation, Outcome and Survival of Ulcerative Colitis PatientsAdmitted to an Intensive Care UnitChristina Y. Ha, Elana A. Maser, Asher Kornbluth

OBJECTIVE: Although the number of inflammatory bowel disease (IBD) related hospitaliza-tions has been increasing over the past decades, the clinical course of IBD patients admittedto an Intensive Care Unit (ICU) has not been clearly defined. The aim of this study was todetermine the incidence of ICU admissions, indications, and risk factors associated with apoorer prognosis and increased mortality among Ulcerative Colitis (UC) patients. METHODS:A retrospective observational study was performed of all patients with a primary diagnosisof UC admitted to the medical or surgical ICU of The Mount Sinai Hospital during the 5-year period from 2003-2008. Data collected included pre-ICU admission risk factors andICU-specific complications including sepsis, respiratory failure, renal failure, and nosocomialinfections. Primary outcomes included 30-day readmission rates and all-cause mortality.RESULTS: Of the 1582 UC-related hospitalizations, 40 (2.5%) required ICU admission. Themean age of ICU pts was 54.9 yrs (range 19-80) compared to 45.9 yrs (range 18-89) fornon-ICU hospitalized UC pts (P=0.0008). The primary indications for ICU admission weremedically refractory UC (70%) and post-operative complications related to elective restorativecolectomy (30%). Among pts admitted to the ICU, 30-day case-fatality rate was 20% and30-day readmission rate was 12.5%. There were no age-related differences in clinical presenta-tion or outcomes among the ICU cohort. All ICU-related deaths were attributed to medically-refractory UC complicated by septic shock. Patients who died were more likely to haverenal failure (P=0.034), respiratory failure (P=0.034), and infection with multi-drug resistantorganisms (P=0.004) than survivors. Patients who died during their ICU admission werealso more likely to be hypoalbuminemic (P=0.004), carry a pre-existing diagnosis of PSC(P=0.01) or a history of liver transplant (P=0.02). The immunosuppressive regimens of theUC pts in the ICU are summarized in the Table. CONCLUSIONS: The 0.5% case-fatalityrate was limited to patients with fulminant UC on intensive immunosuppressive regimens.Further study is needed to determine if earlier patient risk-stratification to direct medicalor surgical decision-making may impact the ICU-related mortality.Medication usage among ICU hospitalized UC patients.

S-539 AGA Abstracts

T1333

Increased Pulse Wave Velocity in Patients With Inflammatory Bowel Diseas.Preliminary Results of an Ongoing StudyEleni Theocharidou, Melachrini Mavroudi, Konstantinos Soufleris, AlexandrosMpoumponaris, Andreas Nakos, Theodora Griva, Nikolaos Grammatikos, Eleni Mavroudi,Geleris Paraschos, Nicolaos Evgenidis

Background and aims. It remains controversial whether inflammatory bowel disease (IBD)patients are predisposed to atherosclerosis, as a result of chronic inflammatory process.Aortic stiffness is a surrogate marker of atherosclerosis and an important predictor ofcardiovascular events. We used non-invasive markers of aortic stiffness -pulse wave velocity(PWV) and augmentation index (AIx)- to assess atherosclerotic burden in such patients.Methods. Common cardiovascular risk factors were assessed in 18 patients with Crohn'sdisease, 6 with ulcerative colitis and 24 healthy controls matched for age, sex, body massindex (BMI) and smoking status. Inflammatory bowel disease patients had no history ofcardiovascular disease and were all on clinical and laboratory remission. Carotid-femoralPWV and AIx were measured using the SphygmoCor CPV system . Results. Pulse wavevelocity was significantly increased in IBD group (6.71±1.05 m/sec) compared to controls(5.79±0.99 m/sec,p=0.003). No significant difference was found in AIx between the twogroups (15.46±15.05 vs 6.75±18.34%,p=0.079). Non-smoking IBD patients (n=13) hadincreased PWV (6.38±0.77 m/sec) compared to non-smoking controls (5.6±0.96 m/sec,p=0.017). Augmentation index was 11.15% (±14.87) in the first group and 5% (±18.55) inthe second group (p=0.324). There was no significant difference in PWV and AIx betweensmoking and non-smoking IBD patients (7.1±1.24 vs 6.38±0.77 m/sec,p=0.115 and20.55±14.26 vs 11.15±14.87%,p=0.130 respectively). Patients on anti-TNF therapy (n=12)had no significant difference in PWV and AIx compared to those on aminosalicylates and/or azathioprine (6.6±1.19 vs 6.8±0.94 m/sec,p=0.638 and 18.25±12.9 vs 12.67±17.04%,p=0.375 respectively), but the first group had longer disease duration (11.25 vs 5.6 years,p=0.053). Nevertheless disease duration correlated neither with PWV (r=0.271,p=0.2) nor withAIx (r=0.299,p=0.156). Conclusion. Inflammatory bowel disease might be associated withearly atherosclerosis as suggested by increased PWV. Anti-TNF therapy did not seem toameliorate the risk in our group of patients. These results should be confirmed in largerstudies, which would also evaluate disease duration as well as pattern of disease and severityof intestinal inflammation.

T1334

Fatigue in Active and Quiescent IBD is Not Related to Serum Levels of Zinc,Carnitine or Pro-Inflammatory CytokinesHarald Peeters, Chloe De Roo, Ana Malfait, Debby Laukens, Martine De Vos

Introduction: Both in active and quiescent Inflammatory Bowel Disease (IBD) patients oftenmention fatigue as a prominent symptom with major impact on daily life. The underlyingmechanisms leading to fatigue in IBD however are not well understood. Studies in otherchronic diseases like chronic fatigue syndrome and malignancies point at specific micronutri-ent deficiencies (zinc and carnitine) as possible causes for fatigue. Aim of the study: Toinvestigate a possible relationship between fatigue and biochemical imbalances in serum orplasma of IBD patients with active disease and patients in remission, with additional focuson inflammatory cytokines, zinc and carnitine. Methods: Ninety-seven consecutive IBDpatients (72 CD, 25 UC) were included at our out-patient clinic. Fatigue was measuredusing the multidimensional CIS questionnaire (Checklist Individual Strength), SFQ(Shortened Fatigue Questionnaire) and VAS (Visual Analog Scale) for fatigue. Disease activitywas assessed using CDAI and UCAI for respectively CD and UC patients. Two thirds ofpatients (n=65) were in clinical remission (CDAI or UCAI≤150). Blood was drawn forextensive routine biochemical and haematological testing (including inflammatory and nutri-tional parameters) and to determine serum levels of IL1, IL6, IL8 and TNFα (ELISA), freeand acylcarnitine (High Performance Liquid Chromatography) and zinc (Atomic AbsorptionSpectrometry). For statistical analysis we used the Spearman correlation coefficient, Mann-Whitney-U and X2 test and logistic regression. Variables were tested both continuously ascategorically. Results: There were no significant correlations between fatigue scores andvalues of complete blood count, CRP/ESR, glucose, creatinine/urea, liver and pancreastests (AST, ALT, γGT, alkalic phosphatase, LDH, amylase, lipase), electrolytes, albumin,immunoglobulines, cortisol, TSH/FT3/FT4, cholesterol/triglycerides, iron/ferritin, vitaminB12, folic acid, vitamin C and Cu/ceruloplasmin. Furthermore, there were no associationswith serum levels of inflammatory cytokines, zinc and carnitine (free and acylcarnitine).Taking into account disease activity, we found no relationship between these parametersand fatigue in subgroups of patients with active disease or IBD in remission. Moreover, nosignificant differences were found between CD and UC patients. Conclusions: This studycould not demonstrate any biochemical ground for fatigue in active or quiescent IBD,including parameters of nutritional status or inflammation and serum levels of zinc and carni-tine.

AG

AA

bst

ract

s