Predictors of severe Crohn's disease
Predictors of severe Crohn's disease
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DOI：
10.1080/00365520801957149
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发表时间：
2008-01-01
影响因子：
1.9
通讯作者：
Louis, Edouard
中科院分区：
文献类型：
--
作者：
Loly, Catherine;Belaiche, Jacques;Louis, Edouard
目标。最近提出了一种基于诊断和预测致残性克罗恩病(CD)早期发展的临床特征的模型，以针对患者进行早期干预。这项研究的目的是确认先前研究中建立的预测因素，并建立以临床上显着的不可逆性损害的发展为特征的严重疾病的预测因素。材料和方法。我们的回顾性研究包括我们临床数据库中的361名CD患者，随访时间超过5年。临床、人口学和生物学因素与CD诊断后5年内致残性疾病的发展(按预先定义的标准)和严重疾病的发展时间(按预先定义的标准)相继进行单因素和多因素分析。结果。诊断后5年内CD致残率为57.9%。肛周病变、需要类固醇治疗首次红肿和回结肠位置，但年龄不低于40岁被确认为预测标记物。重症患病率为37.4%。诊断时的收缩行为(HR：2.11(95%CI：1.39-3.20))和体重减轻(>；5公斤)(HR：1.67(95%CI：1.14-2.45))与严重疾病的发展时间独立相关。所生成的模型的预测性能较低。结论。在我们的患者中，分别有大约三分之一和三分之二的患者出现致残和严重CD。一些临床预测标记物可以找到，甚至得到证实，但它们的表现较低。
Objective. A model based on clinical characteristics at diagnosis and predicting the early development of disabling Crohn's disease (CD) has recently been proposed in order to target patients for early intervention. The objectives of this study were to confirm the predictive factors established in a previous study and to establish the predictive factors for the development of severe disease characterized by the development of clinically significant non-reversible damage. Material and methods. Our retrospective study comprised a total of 361 patients with CD from our clinical database with a follow-up of longer than 5 years. Clinical, demographic and biological factors associated with the development of disabling disease (according to predefined criteria) within 5 years after the diagnosis of CD and with the time to development of severe disease (according to predefined criteria) were successively studied by univariate and multivariate analyses. Results. The rate of disabling CD within 5 years after diagnosis was 57.9%. Perianal lesions, the need for steroids to treat the first flare and ileo-colonic location, but not age below 40 years were confirmed as predictive markers. The rate of severe disease was 37.4%. Stricturing behaviour (HR: 2.11 (95% CI: 1.39-3.20)) and loss of weight (>5kg) (HR: 1.67 (95% CI: 1.14-2.45)) at diagnosis were independently associated with the time to development of severe disease. The predictive performances of the models generated were low. Conclusions. Disabling and severe CD developed in roughly one-third and two-thirds of our patients, respectively. Some clinical predictive markers could be found or even confirmed but their performances were low.