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Risk factors for initial surgery in patients with Crohn’s disease in Central China

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Abstract

Purposes

To establish the risk factors for initial surgery in patients with Crohn’s disease (CD) in Central China.

Methods

The subjects of this study were patients with CD treated at Zhongnan Hospital of Wuhan University, an IBD center in Wuhan City, Central China, between January, 1992 and June, 2012. We conducted uni- and multivariate analyses of the risk factors for initial surgery for CD in these patients.

Results

A total of 197 patients with CD were included in this study. The cumulative incidence of initial surgery was 21.8, 28.9, and 32.5 %, at 1, 5, and 10 years, respectively, after the onset of symptoms. Analysis using multivariate Cox models showed that the relative risk for initial surgery was lower in patients who were younger than 16 years at diagnosis (HR = 0.57, 95 % CI 0.34–0.96, P = 0.034). The risk increased in patients with stricturing (HR = 4.75, 95 % CI 2.48–9.11), those with CD showing penetrating behavior at diagnosis (HR = 5.14, 95 % CI 2.54–10.39), and those with a history of appendectomy (HR = 1.87, 95 % CI 1.03–3.40). Azathioprine (AZA) treatment appeared to decrease the risk for initial surgery in patients with non-penetrating and non-stricturing CD (HR = 0.14, 95 % CI 0.13–3.10).

Conclusion

Age at diagnosis, disease behavior, and a history of appendectomy appeared to have an impact on the risk for initial surgery. AZA treatment might be helpful for decreasing the risk of needing initial surgery for patients in whom stricturing or fistulizing disease has not yet developed.

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Abbreviations

AZA:

Azathioprine

CD:

Crohn’s disease

GI:

Gastrointestinal

IBD:

Inflammatory bowel disease

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Acknowledgments

This study was supported by Grants from Hubei Clinical Center and the Key Laboratory of Intestinal and Colorectal Diseases (2008CC002), the State Public Health Funding of China (20100202), and the National Natural Science Foundation of China (81100265).

Conflict of interest

We have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Zhongnan Hospital of Wuhan University School of Medicine, Donghu Road 169, Wuhan, 430071, People’s Republic of China

    Min Chen, Feng Zhou, Meifang Huang, Jin Li & Bing Xia

  2. The Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, 430071, People’s Republic of China

    Min Chen, Fengming Yi, Feng Zhou, Jin Li, Wenfeng Yan, Lixia Li & Bing Xia

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  1. Min Chen
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  2. Fengming Yi
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  3. Feng Zhou
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  5. Jin Li
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Corresponding author

Correspondence to Min Chen.

Additional information

M. Chen and F. Yi contributed equally to this article.

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Chen, M., Yi, F., Zhou, F. et al. Risk factors for initial surgery in patients with Crohn’s disease in Central China. Surg Today 45, 1002–1008 (2015). https://doi.org/10.1007/s00595-014-1093-z

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  • DOI: https://doi.org/10.1007/s00595-014-1093-z

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