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Risk factors for peristomal pyoderma gangrenosum complicating inflammatory bowel disease.
MedLine Citation:
PMID:  22959399     Owner:  NLM     Status:  Publisher    
BACKGROUND AND AIMS: Risk factors for peristomal pyoderma gangrenosum (PPG) are not well defined. The aim of this study was to evaluate risk factors associated with development of PPG. METHODS: Both PPG patients and controls were obtained by searching a database of the Cleveland Clinic using the ICD-9 code from March 2005 to May 2011. The control group was selected by matching for underlying diseases and type of stoma in a ratio of 3:1. Univariate and multivariate analyses were performed. RESULTS: A total of 15 PPG cases and 45 controls were included. The mean age at the time of PPG diagnosis was 46.0±14.4years. The underlying disease was Crohn's disease in 7 patients (46.7%), ulcerative colitis in 7 (46.7%) and indeterminate colitis in 1 (6.7%). Eleven patients (73.3%) had end ileostomy, 3 (20.0%) had loop ileostomy and 1 (6.7%) had colostomy. Eleven patients (73.3%) had active intestinal disease. In multivariate analysis, female gender, the presence of concurrent autoimmune disorders, and a high body mass index (BMI) were significantly associated with the presence of PPG, with odds ratios of 8.385 (95% confidence interval [CI]: 1.496-46.982, p=0.015), 6.882 (95% CI:1.438-32.941, p=0.016), and 9.895 (95% CI: 1.970-43.704, p=0.005), respectively. After a median follow-up of 12.8 (interquartile range: 7.9-20.1) months with appropriate therapy, PPG healed in 8 patients (53.3%) and improved in 7 (46.7%) patients, after treatment. CONCLUSIONS: Female gender, the presence of autoimmune disorders and a high BMI appeared to be associated with an increased risk for the development of PPG in IBD patients.
Xian-Rui Wu; Saurabh Mukewar; Ravi P Kiran; Feza H Remzi; Jeffery Hammel; Bo Shen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-4
Journal Detail:
Title:  Journal of Crohn's & colitis     Volume:  -     ISSN:  1876-4479     ISO Abbreviation:  J Crohns Colitis     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101318676     Medline TA:  J Crohns Colitis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
Department of Colorectal Surgery, the Cleveland Clinic Foundation, Cleveland, Ohio, USA; Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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