Risk factors associated with progression to intestinal complications of Crohn's disease in a population-based cohort.
Risk factors associated with progression to intestinal complications of Crohn's disease in a population-based cohort.
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DOI：
10.1053/j.gastro.2010.06.070
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发表时间：
2010-10
期刊：
影响因子：
29.4
通讯作者：
Loftus EV Jr
中科院分区：
文献类型：
--
作者：
Thia KT;Sandborn WJ;Harmsen WS;Zinsmeister AR;Loftus EV Jr
我们试图评估美国人群中克罗恩病行为的演变。根据蒙特利尔分类法，对1970年至2004年明尼苏达州奥姆斯特德县所有被诊断为克罗恩病的居民的病历进行了初始临床表型评价。使用Kaplan-Meier方法估计发生结构化和/或穿透并发症的累积概率。比例风险回归用于评估基线风险因素与行为变化之间的关联。在306例患者中，56.2%的患者被诊断为17 - 40岁。病变范围为回肠45.1%，结肠32.0%，回结肠18.6%。基线时，81.4%的患者患有非狭窄性非穿透性疾病，4.6%的患者患有狭窄性疾病，14.0%的患者患有穿透性疾病。诊断后90天发生任一并发症的累积风险为18.6%，1年为22.0%，5年为33.7%，20年为50.8%。在249名基线时患有非狭窄性、非穿透性疾病的患者中，66名在诊断后的前90天内改变了他们的行为。相对于结肠病变范围，回肠、回结肠和上消化道病变范围与行为改变显著相关，而与肛周疾病的相关性几乎不显著。在一项基于人群的队列研究中，18.6%的克罗恩病患者在诊断后90天内发生穿透或狭窄并发症; 50%的患者在诊断后20年发生肠道并发症。与并发症发生相关的因素是回肠受累和肛周疾病。
We sought to assess the evolution of Crohn's disease behavior in an American population-based cohort. The medical records of all Olmsted County, Minnesota residents who were diagnosed with Crohn's disease from 1970 to 2004 were evaluated for their initial clinical phenotype, based on the Montreal classification. The cumulative probabilities of developing structuring and/or penetrating complications were estimated using the Kaplan-Meier method. Proportional hazards regression was used to assess associations between baseline risk factors and changes in behavior. Among 306 patients, 56.2% were diagnosed between the ages of 17 and 40 years. Disease extent was ileal in 45.1%, colonic in 32.0%, and ileocolonic in 18.6%. At baseline, 81.4% had non-stricturing non-penetrating disease, 4.6% had stricturing disease, and 14.0% had penetrating disease. The cumulative risk of developing either complication was 18.6% at 90 days, 22.0% at 1 year, 33.7% at 5 years, and 50.8% at 20 years after diagnosis. Among 249 patients with non-stricturing, non-penetrating disease at baseline, 66 changed their behavior after the first 90 days from diagnosis. Relative to colonic extent, ileal, ileocolonic, and upper gastrointestinal extent were significantly associated with changes in behavior, whereas the association with perianal disease was barely significant. In a population-based cohort study, 18.6% of patients with Crohn's disease experienced penetrating or stricturing complications within 90 days after diagnosis; 50% experienced intestinal complications 20 years after diagnosis. Factors associated with development of complications were the presence of ileal involvement and perianal disease.
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影响因子：
29.4
作者：
Schwartz, DA;Loftus, EV;Sandborn, WJ
通讯作者：
Sandborn, WJ
影响因子：
3.1
作者：
Nos, P;Garrigues, V;Ponce, J
通讯作者：
Ponce, J
影响因子：
29.4
作者：
Loftus, EV;Silverstein, MD;Zinsmeister, AR
通讯作者：
Zinsmeister, AR
影响因子：
29.4
作者：
Beaugerie, L;Seksik, P;Cosnes, J
通讯作者：
Cosnes, J
影响因子：
4.9
作者：
Chow, Dorothy K. L.;Leong, Rupert W. L.;Sung, Joseph J. Y.
通讯作者：
Sung, Joseph J. Y.