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Obesity and Outcome of Crohn’s Associated Perianal Fistula Surgery: A Case-Control Study
BACKGROUND: Evidence suggests that obesity (body mass index (BMI) > 30 kg/m(2)) adversely affects several outcomes in Crohn’s disease (CD). CD-associated perianal fistula (CDPF) represents a debilitating phenotype with a clinical course that may be affected by obesity. We hypothesized that obese...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051028/ https://www.ncbi.nlm.nih.gov/pubmed/27785311 http://dx.doi.org/10.14740/gr698e |
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author | Manne, Ashish Khan, Ali S. Malik, Talha A. |
author_facet | Manne, Ashish Khan, Ali S. Malik, Talha A. |
author_sort | Manne, Ashish |
collection | PubMed |
description | BACKGROUND: Evidence suggests that obesity (body mass index (BMI) > 30 kg/m(2)) adversely affects several outcomes in Crohn’s disease (CD). CD-associated perianal fistula (CDPF) represents a debilitating phenotype with a clinical course that may be affected by obesity. We hypothesized that obese CD patients would be more likely to have poor outcomes following CDPF surgery. METHODS: We designed a case-control study of CD patients who underwent surgery for CDPF between 2000 and 2013 with documented pre-operative BMI and post-operative outcome. Cases and controls were defined based on the outcome of CDPF surgery. Poor outcomes were designated as cases. RESULTS: Of the 317 patients diagnosed with CDPF, 73 patients underwent 120 surgeries for CDPF. Eighty-nine (74%) of the surgeries comprised fistulotomy with or without Seton placement, whereas 31 (26%) were mucosal flap procedures. Twenty-five (21%) cases and 95 (79%) controls were identified. Unadjusted odds ratio (OR) for the association between obesity and outcome demonstrated a trend towards a poor surgical outcome among obese patients that did not reach statistical significance (OR: 1.86; 95% confidence interval (CI): 0.58 - 5.98; P = 0.295). Multivariable logistic regression analysis demonstrated an even stronger trend towards a poor outcome among obese CD patients, albeit without reaching statistical significance (OR: 2.83; 95% CI: 0.64 - 12.49; P = 0.169). CONCLUSION: In patients undergoing Seton placement, fistulotomy or mucosal flap procedure for CDPF, there is a trend towards poor outcomes in the obese; however, as this trend did not reach statistical significance, this association should be examined further. |
format | Online Article Text |
id | pubmed-5051028 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-50510282016-10-26 Obesity and Outcome of Crohn’s Associated Perianal Fistula Surgery: A Case-Control Study Manne, Ashish Khan, Ali S. Malik, Talha A. Gastroenterology Res Original Article BACKGROUND: Evidence suggests that obesity (body mass index (BMI) > 30 kg/m(2)) adversely affects several outcomes in Crohn’s disease (CD). CD-associated perianal fistula (CDPF) represents a debilitating phenotype with a clinical course that may be affected by obesity. We hypothesized that obese CD patients would be more likely to have poor outcomes following CDPF surgery. METHODS: We designed a case-control study of CD patients who underwent surgery for CDPF between 2000 and 2013 with documented pre-operative BMI and post-operative outcome. Cases and controls were defined based on the outcome of CDPF surgery. Poor outcomes were designated as cases. RESULTS: Of the 317 patients diagnosed with CDPF, 73 patients underwent 120 surgeries for CDPF. Eighty-nine (74%) of the surgeries comprised fistulotomy with or without Seton placement, whereas 31 (26%) were mucosal flap procedures. Twenty-five (21%) cases and 95 (79%) controls were identified. Unadjusted odds ratio (OR) for the association between obesity and outcome demonstrated a trend towards a poor surgical outcome among obese patients that did not reach statistical significance (OR: 1.86; 95% confidence interval (CI): 0.58 - 5.98; P = 0.295). Multivariable logistic regression analysis demonstrated an even stronger trend towards a poor outcome among obese CD patients, albeit without reaching statistical significance (OR: 2.83; 95% CI: 0.64 - 12.49; P = 0.169). CONCLUSION: In patients undergoing Seton placement, fistulotomy or mucosal flap procedure for CDPF, there is a trend towards poor outcomes in the obese; however, as this trend did not reach statistical significance, this association should be examined further. Elmer Press 2015-12 2015-12-31 /pmc/articles/PMC5051028/ /pubmed/27785311 http://dx.doi.org/10.14740/gr698e Text en Copyright 2015, Manne et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Manne, Ashish Khan, Ali S. Malik, Talha A. Obesity and Outcome of Crohn’s Associated Perianal Fistula Surgery: A Case-Control Study |
title | Obesity and Outcome of Crohn’s Associated Perianal Fistula Surgery: A Case-Control Study |
title_full | Obesity and Outcome of Crohn’s Associated Perianal Fistula Surgery: A Case-Control Study |
title_fullStr | Obesity and Outcome of Crohn’s Associated Perianal Fistula Surgery: A Case-Control Study |
title_full_unstemmed | Obesity and Outcome of Crohn’s Associated Perianal Fistula Surgery: A Case-Control Study |
title_short | Obesity and Outcome of Crohn’s Associated Perianal Fistula Surgery: A Case-Control Study |
title_sort | obesity and outcome of crohn’s associated perianal fistula surgery: a case-control study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051028/ https://www.ncbi.nlm.nih.gov/pubmed/27785311 http://dx.doi.org/10.14740/gr698e |
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