Jonas Zeitz1, Nicolas Fournier2, Christian Labenz1,3, Luc Biedermann1, Pascal Frei4, Benjamin Misselwitz1, Sylvie Scharl1, Stephan R Vavricka1,5,6, Michael C Sulz7, Michael Fried1,5, Gerhard Rogler1,5, Michael Scharl1,5. 1. Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 2. Institute of Social and Preventive Medicine, Université de Lausanne, Lausanne, Switzerland. 3. Department of Internal Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. 4. Department of Gastroenterology, Gastroenterology Bethanien, University of Zurich, Zurich, Switzerland. 5. Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland. 6. Department of Gastroenterology, Triemli Spital, Zurich, Switzerland. 7. Department of Gastroenterology and Hepatology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Abstract
BACKGROUND: Fistulae and stenoses represent frequent and severe complications in patients with Crohn disease (CD). Our study aimed to identify risk factors for fistula and stenosis formation in CD patients. SUMMARY: We retrieved data of 1,600 CD patients from the nationwide Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS). The risk for fistulae and stenoses in relation to gender, age at diagnosis, smoking status at diagnosis, and ileal involvement at diagnosis were analyzed. In the multivariate analysis, female gender showed a lower risk for developing perianal and any fistula (risk ratio [RR] 0.721, 95% confidence interval [CI] 0.582-0.893, p = 0.003 and RR 0.717, 95% CI 0.580-0.888, p = 0.002, respectively), and older age at diagnosis showed a lower risk for developing perianal fistula (RR 0.661, 95% CI 0.439-0.995, p = 0.047). Furthermore, ileal involvement was associated with a lower risk for perianal fistula (RR 0.713, 95% CI 0.561-0.906, p = 0.006), a lower risk for any fistula (RR 0.709, 95% CI 0.558-0.901, p = 0.005), and a higher risk for stenosis (RR 2.170, 95% CI 1.728-2.725, p < 0.001). KEY MESSAGES: In the nationwide SIBDCS, younger age at diagnosis and male gender were risk factors for developing perianal and nonperianal fistulae. Additionally, ileal involvement was revealed to be a potent risk factor (RR 2.170) for developing a stenosis.
BACKGROUND: Fistulae and stenoses represent frequent and severe complications in patients with Crohn disease (CD). Our study aimed to identify risk factors for fistula and stenosis formation in CD patients. SUMMARY: We retrieved data of 1,600 CD patients from the nationwide Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS). The risk for fistulae and stenoses in relation to gender, age at diagnosis, smoking status at diagnosis, and ileal involvement at diagnosis were analyzed. In the multivariate analysis, female gender showed a lower risk for developing perianal and any fistula (risk ratio [RR] 0.721, 95% confidence interval [CI] 0.582-0.893, p = 0.003 and RR 0.717, 95% CI 0.580-0.888, p = 0.002, respectively), and older age at diagnosis showed a lower risk for developing perianal fistula (RR 0.661, 95% CI 0.439-0.995, p = 0.047). Furthermore, ileal involvement was associated with a lower risk for perianal fistula (RR 0.713, 95% CI 0.561-0.906, p = 0.006), a lower risk for any fistula (RR 0.709, 95% CI 0.558-0.901, p = 0.005), and a higher risk for stenosis (RR 2.170, 95% CI 1.728-2.725, p < 0.001). KEY MESSAGES: In the nationwide SIBDCS, younger age at diagnosis and male gender were risk factors for developing perianal and nonperianal fistulae. Additionally, ileal involvement was revealed to be a potent risk factor (RR 2.170) for developing a stenosis.
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