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Related Factors for Unfavorable Disease Course in Patients with Crohn’s Disease: An Observational Retrospective Study
Background: Crohn’s disease (CD) manifests a heterogeneous clinical spectrum and disease course, and it is challenging to predict the disease outcome based on initial presentation. Objective: To analyze the long-term disease course and factors leading to poor prognosis of CD. Methods: In total, 112...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857483/ https://www.ncbi.nlm.nih.gov/pubmed/36673083 http://dx.doi.org/10.3390/diagnostics13020273 |
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author | Han, Dong Yoon You, Myung-Won Oh, Chi Hyuk Park, Seong Jin |
author_facet | Han, Dong Yoon You, Myung-Won Oh, Chi Hyuk Park, Seong Jin |
author_sort | Han, Dong Yoon |
collection | PubMed |
description | Background: Crohn’s disease (CD) manifests a heterogeneous clinical spectrum and disease course, and it is challenging to predict the disease outcome based on initial presentation. Objective: To analyze the long-term disease course and factors leading to poor prognosis of CD. Methods: In total, 112 patients with CD who were initially diagnosed and treated at our institution from January 2009 to August 2020 were included. We analyzed their clinical data, disease characteristics according to the Montreal classification, and the endoscopic and computed tomography (CT) examinations at the initial visit and at 2-year, 5-year, and last follow ups. We categorized the disease course into the following four categories: remission, stable, chronic refractory, and chronic relapsing. Significant factors associated with a poorer prognosis were analyzed. Results: The median follow-up period was 107 (range, 61–139) months. Complicated disease behavior increased slightly over the follow-up period (20.5% to 26.2%). An unfavorable disease course was defined as chronic refractory (19.6%) and relapsing (16.1%) courses. The 2-year disease characteristics were significant factors for unfavorable disease course, and the combination of 2-year perianal disease and 2-year moderate-to-severe CT activity could predict unfavorable disease course with the highest accuracy (0.722; area under the curve: 0.768; p < 0.0001). Conclusions: One-third of the patients with CD showed an unfavorable disease course (35.7%), and 2-year disease characteristics were significant factors for an unfavorable disease course. |
format | Online Article Text |
id | pubmed-9857483 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98574832023-01-21 Related Factors for Unfavorable Disease Course in Patients with Crohn’s Disease: An Observational Retrospective Study Han, Dong Yoon You, Myung-Won Oh, Chi Hyuk Park, Seong Jin Diagnostics (Basel) Article Background: Crohn’s disease (CD) manifests a heterogeneous clinical spectrum and disease course, and it is challenging to predict the disease outcome based on initial presentation. Objective: To analyze the long-term disease course and factors leading to poor prognosis of CD. Methods: In total, 112 patients with CD who were initially diagnosed and treated at our institution from January 2009 to August 2020 were included. We analyzed their clinical data, disease characteristics according to the Montreal classification, and the endoscopic and computed tomography (CT) examinations at the initial visit and at 2-year, 5-year, and last follow ups. We categorized the disease course into the following four categories: remission, stable, chronic refractory, and chronic relapsing. Significant factors associated with a poorer prognosis were analyzed. Results: The median follow-up period was 107 (range, 61–139) months. Complicated disease behavior increased slightly over the follow-up period (20.5% to 26.2%). An unfavorable disease course was defined as chronic refractory (19.6%) and relapsing (16.1%) courses. The 2-year disease characteristics were significant factors for unfavorable disease course, and the combination of 2-year perianal disease and 2-year moderate-to-severe CT activity could predict unfavorable disease course with the highest accuracy (0.722; area under the curve: 0.768; p < 0.0001). Conclusions: One-third of the patients with CD showed an unfavorable disease course (35.7%), and 2-year disease characteristics were significant factors for an unfavorable disease course. MDPI 2023-01-11 /pmc/articles/PMC9857483/ /pubmed/36673083 http://dx.doi.org/10.3390/diagnostics13020273 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Han, Dong Yoon You, Myung-Won Oh, Chi Hyuk Park, Seong Jin Related Factors for Unfavorable Disease Course in Patients with Crohn’s Disease: An Observational Retrospective Study |
title | Related Factors for Unfavorable Disease Course in Patients with Crohn’s Disease: An Observational Retrospective Study |
title_full | Related Factors for Unfavorable Disease Course in Patients with Crohn’s Disease: An Observational Retrospective Study |
title_fullStr | Related Factors for Unfavorable Disease Course in Patients with Crohn’s Disease: An Observational Retrospective Study |
title_full_unstemmed | Related Factors for Unfavorable Disease Course in Patients with Crohn’s Disease: An Observational Retrospective Study |
title_short | Related Factors for Unfavorable Disease Course in Patients with Crohn’s Disease: An Observational Retrospective Study |
title_sort | related factors for unfavorable disease course in patients with crohn’s disease: an observational retrospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857483/ https://www.ncbi.nlm.nih.gov/pubmed/36673083 http://dx.doi.org/10.3390/diagnostics13020273 |
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