Analysis of the risk of future gastrointestinal surgery in Crohn’s disease with stricture

• DOI: 10.4103/sjg.sjg_256_23
• Publication Date: 2023-10-25T13:01:04Z
• Authors: Wen Zeng; Yong Chen; Bolong Yin; Xue Wen; Jian Xiao; Lian Luo; Haiyuan Tang; He Zheng
• Keywords: stricture; surgery; crohn's disease; Original Article; RC799-869; Diseases of the digestive system. Gastroenterology

Abstract

Background: Stricture in patients with Crohn’s disease (CD) carries a high risk of CD-related surgery in the course of the disease. The aim of this study was to assess the rate of occurrence of CD-related surgery and to determine baseline risk factors predicting subsequent surgery in this patient group.

Methods: Patients registered with stricturing CD were included. All baseline and follow-up data were collected retrospectively. Patients attended the clinic for follow-up at week 14 to assess their response to infliximab (IFX). CD-related surgery was the observational endpoint. Univariate and multivariate Cox regression analyses were used.

Results: A total of 123 patients with stricturing CD were included in this study. The cumulative risk of CD-related surgery for years 1–5 after diagnosis was 18.0%, 26.7%, 32.6%, 40.7%, and 46.4%, respectively. Prior gastrointestinal (GI) surgery, low body mass index (BMI), and high platelet count might be risk factors for future CD-related surgery. With 97 participants treated by IFX, prior GI surgery and primary non-response (PNR) to IFX correlated with future CD-related surgery.

Conclusion: Prior GI surgery, BMI, and platelet counts were related to future CD-related surgery. Patients who were PNR to IFX had a higher risk of CD-related surgery in the future.