Phenotype at diagnosis predicts recurrence rates in Crohn's disease
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Phenotype at diagnosis predicts recurrence rates in Crohn's disease. / Wolters, F L; Russel, M G; Sijbrandij, J; Ambergen, T; Odes, S; Riis, L; Langholz, E; Politi, P; Qasim, A; Koutroubakis, I; Tsianos, E; Vermeire, S; Freitas, J; van Zeijl, G; Hoie, O; Bernklev, T; Beltrami, M; Rodriguez, D; Stockbrügger, R W; Moum, B.
I: Gut, Bind 55, Nr. 8, 08.2006, s. 1124-30.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Phenotype at diagnosis predicts recurrence rates in Crohn's disease
AU - Wolters, F L
AU - Russel, M G
AU - Sijbrandij, J
AU - Ambergen, T
AU - Odes, S
AU - Riis, L
AU - Langholz, E
AU - Politi, P
AU - Qasim, A
AU - Koutroubakis, I
AU - Tsianos, E
AU - Vermeire, S
AU - Freitas, J
AU - van Zeijl, G
AU - Hoie, O
AU - Bernklev, T
AU - Beltrami, M
AU - Rodriguez, D
AU - Stockbrügger, R W
AU - Moum, B
PY - 2006/8
Y1 - 2006/8
N2 - BACKGROUND: In Crohn's disease (CD), studies associating phenotype at diagnosis and subsequent disease activity are important for patient counselling and health care planning.AIMS: To calculate disease recurrence rates and to correlate these with phenotypic traits at diagnosis.METHODS: A prospectively assembled uniformly diagnosed European population based inception cohort of CD patients was classified according to the Vienna classification for disease phenotype at diagnosis. Surgical and non-surgical recurrence rates throughout a 10 year follow up period were calculated. Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease.RESULTS: A total of 358 were classified for phenotype at diagnosis, of whom 262 (73.2%) had a first recurrence and 113 patients (31.6%) a first surgical recurrence during the first 10 years after diagnosis. Patients with upper gastrointestinal disease at diagnosis had an excess risk of recurrence (hazard ratio 1.54 (95% confidence interval (CI) 1.13-2.10)) whereas age >/=40 years at diagnosis was protective (hazard ratio 0.82 (95% CI 0.70-0.97)). Colonic disease was a protective characteristic for resective surgery (hazard ratio 0.38 (95% CI 0.21-0.69)). More frequent resective surgical recurrences were reported from Copenhagen (hazard ratio 3.23 (95% CI 1.32-7.89)).CONCLUSIONS: A mild course of disease in terms of disease recurrence was observed in this European cohort. Phenotype at diagnosis had predictive value for disease recurrence with upper gastrointestinal disease being the most important positive predictor. A phenotypic North-South gradient in CD may be present, illustrated by higher surgery risks in some of the Northern European centres.
AB - BACKGROUND: In Crohn's disease (CD), studies associating phenotype at diagnosis and subsequent disease activity are important for patient counselling and health care planning.AIMS: To calculate disease recurrence rates and to correlate these with phenotypic traits at diagnosis.METHODS: A prospectively assembled uniformly diagnosed European population based inception cohort of CD patients was classified according to the Vienna classification for disease phenotype at diagnosis. Surgical and non-surgical recurrence rates throughout a 10 year follow up period were calculated. Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease.RESULTS: A total of 358 were classified for phenotype at diagnosis, of whom 262 (73.2%) had a first recurrence and 113 patients (31.6%) a first surgical recurrence during the first 10 years after diagnosis. Patients with upper gastrointestinal disease at diagnosis had an excess risk of recurrence (hazard ratio 1.54 (95% confidence interval (CI) 1.13-2.10)) whereas age >/=40 years at diagnosis was protective (hazard ratio 0.82 (95% CI 0.70-0.97)). Colonic disease was a protective characteristic for resective surgery (hazard ratio 0.38 (95% CI 0.21-0.69)). More frequent resective surgical recurrences were reported from Copenhagen (hazard ratio 3.23 (95% CI 1.32-7.89)).CONCLUSIONS: A mild course of disease in terms of disease recurrence was observed in this European cohort. Phenotype at diagnosis had predictive value for disease recurrence with upper gastrointestinal disease being the most important positive predictor. A phenotypic North-South gradient in CD may be present, illustrated by higher surgery risks in some of the Northern European centres.
KW - Adult
KW - Age Factors
KW - Crohn Disease/diagnosis
KW - Epidemiologic Methods
KW - Humans
KW - Middle Aged
KW - Phenotype
KW - Prognosis
KW - Recurrence
U2 - 10.1136/gut.2005.084061
DO - 10.1136/gut.2005.084061
M3 - Journal article
C2 - 16361306
VL - 55
SP - 1124
EP - 1130
JO - Gut
JF - Gut
SN - 0017-5749
IS - 8
ER -
ID: 219530149