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Upper Gastrointestinal Tract Involvement in Crohn's Disease: Frequency, Risk Factors, and Disease Course.
- Source :
-
Journal of Crohn's & colitis [J Crohns Colitis] 2018 Nov 28; Vol. 12 (12), pp. 1399-1409. - Publication Year :
- 2018
-
Abstract
- Background: The frequency of upper gastrointestinal [GI] tract involvement in Crohn`s disease [CD] has been reported with a large variation. Risk factors and disease course of patients with upper GI tract involvement remain largely elusive.<br />Methods: Data on CD patients in the Swiss Inflammatory Bowel Disease Cohort were analysed. Patients with upper GI tract involvement were compared with controls. Logistic regression models for prediction of upper GI tract involvement and Cox proportional hazard models for occurrence of complications were computed.<br />Results: We included 1638 CD patients, of whom 107 [6.5%] presented with upper GI tract involvement at the time of diagnosis and 214 [13.1%] at any time. Prevalence of such involvement at diagnosis increased over time [5.1% for 1955-95 versus 11.3% for 2009-16]. In a multivariate logistic regression model, male sex and diagnosis between 2009 and 2016 [versus before 1995] were independent predictors for presence of upper GI tract involvement at CD diagnosis (odds ratio [OR] 1.600, p = 0.021 and OR 2.686, p < 0.001, respectively), whereas adult age was a negative predictor [OR 0.388, p = 0.001]. Patients with upper GI tract involvement showed a disease course similar to control patients (hazard ratio [HR] for any complications 0.887, (95% confidence interval [CI] 0.409-1.920), and a trend towards occurrence of fewer intestinal fistulas [log-rank test p = 0.054].<br />Conclusions: Prevalence of upper GI tract involvement has been increasing over the past decades. Male sex and young age at diagnosis were identified as the main predictive factors for such involvement at CD diagnosis. Involvement of upper GI tract did not result in a worse outcome.
- Subjects :
- Adult
Age Factors
Disease Progression
Female
Humans
Logistic Models
Male
Predictive Value of Tests
Prevalence
Proportional Hazards Models
Risk Assessment
Risk Factors
Sex Factors
Switzerland epidemiology
Crohn Disease complications
Crohn Disease diagnosis
Crohn Disease epidemiology
Crohn Disease physiopathology
Intestinal Fistula epidemiology
Intestinal Fistula etiology
Upper Gastrointestinal Tract pathology
Upper Gastrointestinal Tract physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1876-4479
- Volume :
- 12
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of Crohn's & colitis
- Publication Type :
- Academic Journal
- Accession number :
- 30165603
- Full Text :
- https://doi.org/10.1093/ecco-jcc/jjy121