The Clinical Characteristics and Prognosis of Crohn’s Disease in Korean Patients Showing Proximal Small Bowel Involvement: Results from the CONNECT Study
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Background/Aims: We aimed to evaluate the clinical characteristics and prognosis of Crohn’s disease (CD) in patients who showed proximal small bowel involvement using a nationwide Korean CD cohort. Methods: We reviewed the data from a cohort of patients diagnosed with CD. The clinical outcomes of patients were evaluated according to the presence of proximal small bowel involvement. Results: Among 1,329 patients with CD for whom complete disease location data were available, 222 patients (16.7%) showed involvement of the proximal small bowel. Compared to patients without proximal small bowel involvement, those with small bowel involvement were more likely to display stricturing behavior (19.8% vs 12.7%, p=0.020). The surgery-free survival of patients who showed proximal small bowel involvement was inferior to that of patients without proximal small bowel involvement (10-year surgery-free survival: 58.4% vs 67.7%, respectively, p<0.001). Additionally, upper gastrointestinal involvement was more common in patients with proximal small bowel involvement than in those without involvement (odds ratio, 1.643; 95% confidence interval, 1.008 to 2.677). Conclusions: Proximal small bowel involvement is a poor prognostic factor for the surgery-free survival of Korean patients with CD. Proximal small bowel involvement should be evaluated in patients with CD for predicting long-term clinical outcomes.
Abstract
Background/Aims: We aimed to evaluate the clinical characteristics and prognosis of Crohn’s disease (CD) in patients who showed proximal small bowel involvement using a nationwide Korean CD cohort. Methods: We reviewed the data from a cohort of patients diagnosed with CD. The clinical outcomes of patients were evaluated according to the presence of proximal small bowel involvement. Results: Among 1,329 patients with CD for whom complete disease location data were available, 222 patients (16.7%) showed involvement of the proximal small bowel. Compared to patients without proximal small bowel involvement, those with small bowel involvement were more likely to display stricturing behavior (19.8% vs 12.7%, p=0.020). The surgery-free survival of patients who showed proximal small bowel involvement was inferior to that of patients without proximal small bowel involvement (10-year surgery-free survival: 58.4% vs 67.7%, respectively, p<0.001). Additionally, upper gastrointestinal involvement was more common in patients with proximal small bowel involvement than in those without involvement (odds ratio, 1.643; 95% confidence interval, 1.008 to 2.677). Conclusions: Proximal small bowel involvement is a poor prognostic factor for the surgery-free survival of Korean patients with CD. Proximal small bowel involvement should be evaluated in patients with CD for predicting long-term clinical outcomes.
참고문헌 (20)
- Freeman HJ, "Natural history and long-term clinical course of Crohn's disease", World J Gastroenterol, 20, pp.31~36 (2014)[DOI]
- Keh C, "Jejunal Crohn's disease is associated with a higher postoperative recurrence rate than ileocaecal Crohn's disease", Colorectal Dis, 7, pp.366~368 (2005)[DOI]
- Lazarev M, "Relationship between proximal Crohn's disease location and disease behavior and surgery: a cross-sectional study of the IBD Genetics Consortium", Am J Gastroenterol, 108, pp.106~112 (2013)[DOI]
- Peyrin-Biroulet L, "The natural history of adult Crohn's disease in population-based cohorts", Am J Gastroenterol, 105, pp.289~297 (2010)[DOI]
- Jess T, "Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades: a population-based study from Copenhagen, Denmark", Inflamm Bowel Dis, 13, pp.481~489 (2007)[DOI]
- Thia KT, "Risk factors associated with progression to intestinal complications of Crohn's disease in a population-based cohort", Gastroenterology, 139, pp.1147~1155 (2010)[DOI]
- Molodecky NA, "Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review", Gastroenterology, 142, pp.46~54 (2012)[DOI]
- Goh K, "Inflammatory bowel disease: a survey of the epidemiology in Asia", J Dig Dis, 10, pp.1~6 (2009)[DOI]
- Wee Khoon Ng, "Changing epidemiological trends of inflammatory bowel disease in Asia", Intestinal research, 14(2), pp.111~119 (2016), 대한장연구학회
- Yang SK, "Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: a KASID study", Inflamm Bowel Dis, 14, pp.542~549 (2008)[DOI]
- Doh YS, "The clinical characteristics of patients with free perforation in Korean Crohn's disease: results from the CONNECT study", BMC Gastroenterol, 15, pp.31~ (2015)[DOI]
- Moon CM, "Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients: results from the CONNECT study", PLoS One, 10, pp.e0144390~ (2015)[DOI]
- 천재희, "Crohn’s Disease Clinical Network and Cohort (CONNECT) Study: The First Step Toward Nationwide Multicenter Research of Crohn’s Disease in Korea", Intestinal research, 12(3), pp.173~175 (2014), 대한장연구학회
- 예병덕, "크론병 진단 가이드라인", 대한소화기학회지, 53(3), pp.161~176 (2009), 대한소화기학회
- Silverberg MS, "Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology", Can J Gastroenterol, 19(Suppl A), pp.5A~36A (2005)[DOI]
- Kang B, "Mucosal healing in paediatric patients with moderate-to-severe luminal Crohn's disease under combined immunosuppression: escalation versus early treatment", J Crohns Colitis, 10, pp.1279~1286 (2016)[DOI]
- Freeman HJ, "Long-term clinical behavior of jejunoileal involvement in Crohn's disease", Can J Gastroenterol, 19, pp.575~578 (2005)[DOI]
- Park SK, "Long-term prognosis of the jejunal involvement of Crohn's disease", J Clin Gastroenterol, 47, pp.400~408 (2013)[DOI]
- Thia KT, "An update on the epidemiology of inflammatory bowel disease in Asia", Am J Gastroenterol, 103, pp.3167~3182 (2008)[DOI]
- Pin-Jin Hu, "Inflammatory Bowel Disease in Asia: The Challenges and Opportunities", Intestinal research, 13(3), pp.188~190 (2015), 대한장연구학회
