Long-term incidence and characteristics of intestinal failure in Crohn's disease: a multicenter study
Long-term incidence and characteristics of intestinal failure in Crohn's disease: a multicenter study
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DOI：
10.1007/s00535-013-0797-y
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发表时间：
2014-02-01
影响因子：
6.3
通讯作者：
Watanabe, Mamoru
中科院分区：
文献类型：
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作者：
Watanabe, Kazuhiro;Sasaki, Iwao;Watanabe, Mamoru
本研究的目的是阐明克罗恩病（CD）患者肠衰竭（IF）的风险和特征。本研究是对12家医院的回顾性研究。收集1970年至2009年间在12家医院中的任何一家接受首次手术的乳糜泻患者（n = 1,703）。对发生IF的患者进行回顾（n = 68），并通过Kaplan-Meier方法分析IF的累积风险。此外，还回顾了在其他医院接受初始手术，然后在12家医院中的任何一家接受治疗的IF患者（n = 33）。因此，我们共收集了101例IF患者，并分析了IF相关死亡的累积风险。初次手术后IF的累积风险分别为0.8%（5年）、3.6%（10年）、6.1%（15年）和8.5%（20年）。在合并IF的CD患者中，初始手术时的平均年龄、IF发生时的平均年龄和研究时的当前年龄分别为28.2岁、38.2岁和46.1岁。每位患者平均手术次数为3.3次。残余小肠平均长度为163 cm。12例IF患者（12%）死亡，发生IF相关死亡的累积风险分别为1.1%（3年）、3.7%（5年）、6.5%（7年）和8.9%（10年）。长期来看，乳糜泻患者发生干扰素和干扰素相关死亡并不罕见。迫切需要制定预防和管理IF的战略。
The aim of this study was to clarify the risk and characteristics of intestinal failure (IF) in patients with Crohn's disease (CD).The present study was a retrospective study in 12 hospitals. CD patients who underwent initial surgery at any of the 12 hospitals between 1970 and 2009 were collected (n = 1,703). Those who developed IF were reviewed (n = 68), and the cumulative risk of IF was analyzed by the Kaplan-Meier method. In addition, IF patients who underwent initial surgery at other hospitals and were then treated at any of the 12 hospitals were also reviewed (n = 33). Thus, a total of 101 IF patients were collected, and the cumulative risk of IF-related death was analyzed.The cumulative risk of IF after the initial surgery was 0.8 % (5 years), 3.6 % (10 years), 6.1 % (15 years), and 8.5 % (20 years). In CD patients with IF, mean age at initial surgery, IF occurrence, and present age at the time of the study were 28.2, 38.2, and 46.1 years, respectively. The mean number of surgeries per patient was 3.3. The mean length of the remnant small bowel was 163 cm. Twelve IF patients (12 %) had died and the cumulative risk of IF-related death by the time from the occurrence of IF was 1.1 % (3 years), 3.7 % (5 years), 6.5 % (7 years), and 8.9 % (10 years).The occurrence of IF and IF-related death in CD patients is not rare over the long term. There is a pressing need to develop strategies for the prevention and management of IF.