Document Detail


Risk factors for early postoperative recurrence of Crohn's disease.
MedLine Citation:
PMID:  9679030     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Despite many advances in our understanding of Crohn's disease, the course of the disease in any given patient remains unpredictable. There is little agreement as to which factors increase a patient's risk of early postoperative recurrence. We have attempted to identify predictors of early recurrence after surgical resection, specifically whether the indication for initial surgery (perforating or nonperforating) or the duration of preoperative disease may be associated with early recurrence. METHODS: We studied 88 patients who had undergone at least two resections for Crohn's disease. Multivariable survival analysis was performed to elucidate predictors of early postoperative recurrence. RESULTS: A perforating indication for initial surgery (P < 0.001) and a longer preoperative disease duration (P = 0.004) were found to be the only independent predictors of earlier postoperative recurrence after initial surgery. A longer preoperative disease duration also showed a borderline significant association with a shorter interval from second to third surgery (P = 0.075). Finally, the indication for initial surgery was predictive of the indication at a subsequent surgery for recurrence (P = 0.001). CONCLUSIONS: A perforating indication for initial resection and a longer duration of disease before initial surgery predicted an earlier postoperative recurrence. The latter association was borderline. This suggests that prognostic groups based on these factors may help to stratify patients with regard to risk of early recurrence.
Authors:
E Lautenbach; J A Berlin; G R Lichtenstein
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastroenterology     Volume:  115     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-09-25     Completed Date:  1998-09-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  259-67     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Crohn Disease / surgery*
Female
Forecasting
Humans
Male
Middle Aged
Multivariate Analysis
Postoperative Complications*
Recurrence
Retrospective Studies
Risk Factors
Survival Analysis
Time Factors
Comments/Corrections
Comment In:
Gastroenterology. 1999 Apr;116(4):1013-4   [PMID:  10092331 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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