Jong Wook Kim1, Ho-Su Lee2,3, Byong Duk Ye4,5, Suk-Kyun Yang2,6, Sung Wook Hwang2, Sang Hyoung Park2,6, Dong-Hoon Yang2, Kyung-Jo Kim2,6, Jeong-Sik Byeon2, Seung-Jae Myung2, Yong Sik Yoon6,7, Chang Sik Yu6,7, Jin-Ho Kim2. 1. Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea. 2. Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 3. Department of Health Screening and Promotion Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 4. Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. bdye@amc.seoul.kr. 5. Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. bdye@amc.seoul.kr. 6. Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 7. Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Abstract
BACKGROUND: Incidence of and risk factors for intestinal free perforation (FP) in patients with Crohn's disease (CD) are not established. AIM: To establish rate of and risk factors for FP in a large cohort of CD patients. METHODS: Medical records of CD patients who visited Asan Medical Center from June 1989 to December 2012 were reviewed. After matching the FP patients to controls (1:4) by gender, year, and age at CD diagnosis, and disease location, their clinical characteristics were compared using conditional logistic regression analysis. RESULTS: Among 2043 patients who were included in our study cohort, 44 patients (2.15%) developed FP over a median follow-up period of 79.8 months (interquartile range 37.3-124.6), with an incidence of 3.18 per 1000 person-years [95% confidence interval (CI) 2.37-4.28]. All 44 patients underwent emergency surgery, and eight patients underwent reoperation within 12 months (8/44, 18.2%). Multivariable-adjusted analysis revealed that anti-TNF therapy [odds ratio (OR), 3.73; 95% CI 1.19-11.69; p = 0.024] was associated with an increased risk of FP. CONCLUSIONS: The incidence of FP in a large cohort of Korean CD patients was 2.15%, which was similar to that in Western reports. Anti-TNF therapy could be risk factors for FP.
BACKGROUND: Incidence of and risk factors for intestinal free perforation (FP) in patients with Crohn's disease (CD) are not established. AIM: To establish rate of and risk factors for FP in a large cohort of CDpatients. METHODS: Medical records of CDpatients who visited Asan Medical Center from June 1989 to December 2012 were reviewed. After matching the FP patients to controls (1:4) by gender, year, and age at CD diagnosis, and disease location, their clinical characteristics were compared using conditional logistic regression analysis. RESULTS: Among 2043 patients who were included in our study cohort, 44 patients (2.15%) developed FP over a median follow-up period of 79.8 months (interquartile range 37.3-124.6), with an incidence of 3.18 per 1000 person-years [95% confidence interval (CI) 2.37-4.28]. All 44 patients underwent emergency surgery, and eight patients underwent reoperation within 12 months (8/44, 18.2%). Multivariable-adjusted analysis revealed that anti-TNF therapy [odds ratio (OR), 3.73; 95% CI 1.19-11.69; p = 0.024] was associated with an increased risk of FP. CONCLUSIONS: The incidence of FP in a large cohort of Korean CDpatients was 2.15%, which was similar to that in Western reports. Anti-TNF therapy could be risk factors for FP.
Authors: Mark S Silverberg; Jack Satsangi; Tariq Ahmad; Ian D R Arnott; Charles N Bernstein; Steven R Brant; Renzo Caprilli; Jean-Frédéric Colombel; Christoph Gasche; Karel Geboes; Derek P Jewell; Amir Karban; Edward V Loftus; A Salvador Peña; Robert H Riddell; David B Sachar; Stefan Schreiber; A Hillary Steinhart; Stephan R Targan; Severine Vermeire; B F Warren Journal: Can J Gastroenterol Date: 2005-09 Impact factor: 3.522