Background And Aims: Crohn's disease (CD) is an inflammatory bowel disease (IBD) caused by a combination of genetic, clinical, and environmental factors. Identification of CD patients at high risk of requiring surgery may assist clinicians to decide on a top-down or step-up treatment approach.
Methods: We conducted a retrospective case-control analysis of a population-based cohort of 503 CD patients. A regression-based data reduction approach was used to systematically analyse 63 genomic, clinical and environmental factors for association with IBD-related surgery as the primary outcome variable.
Results: A multi-factor model was identified that yielded the highest predictive accuracy for need for surgery. The factors included in the model were the NOD2 genotype (OR = 1.607, P = 2.3 × 10(-5)), having ever had perianal disease (OR = 2.847, P = 4 × 10(-6)), being post-diagnosis smokers (OR = 6.312, P = 7.4 × 10(-3)), being an ex-smoker at diagnosis (OR = 2.405, P = 1.1 × 10(-3)) and age (OR = 1.012, P = 4.4 × 10(-3)). Diagnostic testing for this multi-factor model produced an area under the curve of 0.681 (P = 1 × 10(-4)) and an odds ratio of 3.169, (95% CI P = 1 × 10(-4)) which was higher than any factor considered independently.
Conclusions: The results of this study require validation in other populations but represent a step forward in the development of more accurate prognostic tests for clinicians to prescribe the most optimal treatment approach for complicated CD patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s11605-013-2250-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Effect of Low-dose Aspirin on Disease Activity in Pregnant Individuals with Inflammatory Bowel Disease.
Am J Gastroenterol
January 2025
Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, CA, USA.
Objectives: Low-dose aspirin (LDA) is recommended for pregnant individuals at elevated risk for hypertensive disorders of pregnancy (HDP). However, regular aspirin use may raise concerns of increased disease activity in patients with inflammatory bowel disease (IBD). We aimed to evaluate the prevalence of LDA use in pregnant IBD patients and the effect of LDA on IBD disease activity.
View Article and Find Full Text PDFCharacterization of Inflammatory Bowel Disease in the Elderly According to Age of Onset.
J Clin Med
December 2024
UGC de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma BIONAD, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain.
: Elderly populations are under-represented in inflammatory bowel disease (IBD) clinical trials, with limited data on phenotype, treatment patterns, outcomes, and comorbidities. The main objective of this study was to evaluate, in an elderly cohort with IBD, demographic and disease characteristics, comorbidity, polypharmacy, and treatment patterns according to the development of IBD at or before old age. Secondarily, the same analysis was performed based on the type of IBD: ulcerative colitis (UC) or Crohn's disease (CD).
View Article and Find Full Text PDFInflammatory Bowel Diseases and Nephropathies: Exploring the Gut-Kidney Axis.
Life (Basel)
November 2024
IBD Unit, Department of Clinical Medicine and Surgery, University Federico II, 80126 Naples, Italy.
Inflammatory bowel disease (IBD) can extend beyond the gastrointestinal tract, affecting extraintestinal organs and significantly increasing morbidity and mortality. Despite early studies revealing kidney involvement in nearly a quarter of patients with IBD, renal manifestations have been notably overlooked. Among these manifestations, nephrolithiasis, obstructive uropathy, and fistula formation between the bowel and urinary tract are the most reported occurrences.
View Article and Find Full Text PDFA Complicated Matter: Predictors for Postoperative Infections After Bowel Resection in Pediatric Inflammatory Bowel Disease.
J Pediatr Surg
December 2024
Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
Article Synopsis
- The study focused on pediatric patients with inflammatory bowel disease (IBD) who underwent bowel resection to understand the incidence of postoperative infections and associated symptoms.
- Out of 100 patients reviewed, 42 experienced postoperative infections, predominantly superficial surgical site infections; fever was a significant indicator of infection, affecting more than half of those with fever.
- Preoperative immunomodulating therapy did not result in higher complication rates, and routine lab tests, like C-reactive protein levels, did not effectively distinguish between complications in postoperative recovery.
Predictive Model for Outcomes in Inflammatory Bowel Disease Patients Receiving Maintenance Infliximab Therapy.
Crohns Colitis 360
October 2024
Department of Gastroenterology, University of Montreal, Montreal, Quebec, Canada.
Background: No models predict future outcomes in inflammatory bowel disease (IBD) patients receiving maintenance infliximab therapy. We created a predictive model for unfavorable outcomes.
Methods: Adult patients with IBD receiving maintenance infliximab therapy at 2 centers with matched serum infliximab concentrations and blinded histologic scores (Robarts Histopathologic Index [RHI]) were included.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!