Penetrating or stricturing diseases are the major determinants of time to first and repeat resection surgery in Crohn's disease
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BORIS DOI
Publisher DOI
PubMed ID
23711401
Description
BACKGROUND
About 80% of patients with Crohn's disease (CD) require bowel resection and up to 65% will undergo a second resection within 10 years. This study reports clinical risk factors for resection surgery (RS) and repeat RS.
METHODS
Retrospective cohort study, using data from patients included in the Swiss Inflammatory Bowel Disease Cohort. Cox regression analyses were performed to estimate rates of initial and repeated RS.
RESULTS
Out of 1,138 CD cohort patients, 417 (36.6%) had already undergone RS at the time of inclusion. Kaplan-Meier curves showed that the probability of being free of RS was 65% after 10 years, 42% after 20 years, and 23% after 40 years. Perianal involvement (PA) did not modify this probability to a significant extent. The main adjusted risk factors for RS were smoking at diagnosis (hazard ratio (HR) = 1.33; p = 0.006), stricturing with vs. without PA (HR = 4.91 vs. 4.11; p < 0.001) or penetrating disease with vs. without PA (HR = 3.53 vs. 4.58; p < 0.001). The risk factor for repeat RS was penetrating disease with vs. without PA (HR = 3.17 vs. 2.24; p < 0.05).
CONCLUSION
The risk of RS was confirmed to be very high for CD in our cohort. Smoking status at diagnosis, but mostly penetrating and stricturing diseases increase the risk of RS.
About 80% of patients with Crohn's disease (CD) require bowel resection and up to 65% will undergo a second resection within 10 years. This study reports clinical risk factors for resection surgery (RS) and repeat RS.
METHODS
Retrospective cohort study, using data from patients included in the Swiss Inflammatory Bowel Disease Cohort. Cox regression analyses were performed to estimate rates of initial and repeated RS.
RESULTS
Out of 1,138 CD cohort patients, 417 (36.6%) had already undergone RS at the time of inclusion. Kaplan-Meier curves showed that the probability of being free of RS was 65% after 10 years, 42% after 20 years, and 23% after 40 years. Perianal involvement (PA) did not modify this probability to a significant extent. The main adjusted risk factors for RS were smoking at diagnosis (hazard ratio (HR) = 1.33; p = 0.006), stricturing with vs. without PA (HR = 4.91 vs. 4.11; p < 0.001) or penetrating disease with vs. without PA (HR = 3.53 vs. 4.58; p < 0.001). The risk factor for repeat RS was penetrating disease with vs. without PA (HR = 3.17 vs. 2.24; p < 0.05).
CONCLUSION
The risk of RS was confirmed to be very high for CD in our cohort. Smoking status at diagnosis, but mostly penetrating and stricturing diseases increase the risk of RS.
Date of Publication
2013
Publication Type
Article
Subject(s)
500 - Science::570 - Life sciences; biology
600 - Technology::610 - Medicine & health
Keyword(s)
Crohn’s disease
•
Epidemiology
•
Surgery for IBD
Language(s)
en
Contributor(s)
Pittet, Valerie | |
Rogler, Gerhard | |
Michetti, Pierre | |
Fournier, Nicolas | |
Vader, John-Paul | |
Schoepfer, Alain | |
Mottet, Christian | |
Burnand, Bernard | |
Froehlich, Florian | |
Swiss IBD, Cohort Study Group |
Additional Credits
Institut für Pathologie
Series
Digestion
Publisher
Karger
ISSN
0012-2823
Access(Rights)
open.access