SMOKING-HABITS AND RECURRENCE IN CROHNS-DISEASE
SMOKING-HABITS AND RECURRENCE IN CROHNS-DISEASE
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DOI：
10.1016/0016-5085(94)90697-1
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发表时间：
1994-03-01
期刊：
影响因子：
29.4
通讯作者：
PAGLIARO, L
中科院分区：
文献类型：
--
作者：
COTTONE, M;ROSSELLI, M;PAGLIARO, L
背景/目的：吸烟可能是克罗恩病手术复发的危险因素。然而，与复发相关的其他变量可能是吸烟的混杂因素。本研究的目的是评估吸烟作为临床、手术和内窥镜复发的独立预测因子的作用。方法：对182例接受克罗恩病手术的患者进行多因素分析，包括与复发相关的所有重要变量：性别、诊断时年龄、症状发作和手术之间的时间、疾病部位、手术指征、疾病程度、肠外表现和吸烟习惯。结果：通过Cox比例风险模型，临床复发的独立预测因素为吸烟（风险比为1.46；95%可信区间[Cl]为1.1-1.8）、肠外表现（风险比为1.61；95% Cl为1.0-2.5）和疾病程度（风险比为1.57；95% Cl为1.0-2.4）。吸烟是手术复发的唯一显著预测因素（危险比，2.0;95% Cl, 1.2-2.3）。对于内镜下复发，logistic回归显示吸烟（优势比为2.2;95% Cl, 1.2-3.8）和疾病程度（优势比为2.6;95% Cl, 1.0-6.7）是复发的预测因素。结论：吸烟是克罗恩病临床、手术和内镜下复发的独立危险因素。
Background/Aims:Smoking may be a risk factor for surgical recurrence of Crohn's disease. However, other variables associated with recurrence could be confounding factors for smoking. The aim of this study was to evaluate the role of smoking as an independent predictor of clinical, surgical, and endoscopic recurrence.Methods:In a series of 182 patients who underwent surgery for Crohn's disease, a multivariate analysis was performed that included all of the significant variables associated with recurrence: sex, age at diagnosis, time between onset of symptoms and surgery, site of disease, indication for surgery, extent of disease, extraintestinal manifestation, and smoking habit.Results:Independent predictors of clinical recurrence by the Cox proportional hazard model were smoking (hazard ratio, 1.46; 95% confidence interval [Cl], 1.1–1.8), extraintestinal manifestations (hazard ratio, 1.61; 95% Cl, 1.0–2.5), and extent of disease (hazard ratio, 1.57; 95% Cl, 1.0–2.4). Smoking was the only significant predictor of surgical recurrence (hazard ratio, 2.0; 95% Cl, 1.2–2.3). For endoscopic recurrence, logistic regression showed that smoking (odds ratio, 2.2; 95% Cl, 1.2–3.8) and extent of disease (odds ratio, 2.6; 95% Cl, 1.0–6.7) were predictive factors of recurrence.Conclusions:Smoking is an independent risk factor for clinical, surgical, and endoscopic recurrence in Crohn's disease.