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Risk Factors for Postoperative Recurrence in Korean Patients with Crohn’s Disease
- Source :
- Gut and Liver
- Publication Year :
- 2020
- Publisher :
- The Editorial Office of Gut and Liver, 2020.
-
Abstract
- Background/Aims: A considerable number of patients with Crohn’s disease still need intestinal resection surgery. Postoperative recurrence is an important issue in Crohn’s disease management, including the selection of high-risk patients. Eastern Asian patients showed several differences from Caucasian patients. Therefore, we investigated the postoperative surgical recurrence outcome and identified risk factors in Korean patients. Methods: Clinical data of 372 patients with Crohn’s disease who underwent first intestinal resection between January 2004 and August 2014 at 14 hospitals in Korea were retrospectively reviewed. Results: Over the follow-up period, 50 patients (17.1%) showed surgi cal recurrence. The cumulative surgical recurrence rate was 6.5% at 1 year and 15.4% at 7 years. Age under 16 (p=0.011; hazard ratio [HR], 5.136; 95% confidence interval [CI], 1.576 to 16.731), colonic involvement (p=0.023; HR , 2.011; 95% CI, 1.102 to 3.670), and the presence of perianal disease at surgery (p=0.008; HR, 2.239; 95% CI, 1.236 to 4.059) were independent risk factors associated with surgical recurrence. Postoperative thiopurine treatment (p=0.002; HR, 0.393; 95% CI, 0.218 to 0.710) was a protective factor for surgical recurrence. Conclusions: Among the disease characteristics at surgery, younger age, colonic location, and perianal le sions were independent risk factors for surgical recurrence. Postoperative thiopurine treatment significantly reduced the incidence of surgical recurrence. (Gut Liver 2020;14:331-337)
- Subjects :
- Adult
Male
medicine.medical_specialty
Younger age
Adolescent
Protective factor
Disease
Gastroenterology
Endoscopy, Gastrointestinal
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Recurrence
Internal medicine
Republic of Korea
medicine
Humans
Postoperative Period
Crohn's disease
Thiopurine
Hepatology
Thiopurine methyltransferase
biology
business.industry
Incidence
Incidence (epidemiology)
Hazard ratio
Crohn disease
medicine.disease
Confidence interval
Treatment Outcome
Risk factors
030220 oncology & carcinogenesis
biology.protein
Original Article
Surgery
Female
030211 gastroenterology & hepatology
business
Subjects
Details
- ISSN :
- 20051212 and 19762283
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Gut and Liver
- Accession number :
- edsair.doi.dedup.....0fcbe24196613c413ed3a20d570e9fac