BACKGROUND: Many patients with Crohn's disease will develop complications that require surgery. Recurrence after surgery is common. AIM: To assess racial differences in postoperative recurrence between African-Americans and Caucasians. METHODS: Medical records of Crohn's disease patients who underwent surgery (ileal, colonic, or ileocolonic resection) between June 2014 and June 2016 were reviewed. The primary endpoints were clinical and endoscopic remission at 6-12 months after a Crohn's disease surgery. Secondary outcomes included biological and histologic remission. Risks of recurrence were assessed by univariate, multivariate, and propensity score-matched analysis. RESULTS: Thirty-six African-American and 167 Caucasian patients with Crohn's disease were included for analysis. There was no difference in disease location, disease behaviour, type of surgery performed, and pre- or postoperative medication use between the two groups. The rate of endoscopic remission did not differ between African-American and Caucasian patients (50% vs 42%, P = 0.76), and race did not influence the risk of endoscopic recurrence on univariate, multivariate, or propensity score-matched analysis. The rate of clinical remission was significantly lower in African-American patients compared to Caucasian patients (36% vs. 63%, P = 0.008). African-American race was significantly associated with clinical recurrence on univariate (odds ratio (OR) 6.76, 95% CI 1.50-30.40; P = 0.01), multivariate (OR 5.02, 95% CI 1.60-15.80; P = 0.006), and propensity-matched analysis (68% vs. 32% in Caucasians, P = 0.005). Rates of biologic and histologic remission were similar between the two groups on all analyses. CONCLUSIONS: We found that African-American patients with Crohn's disease have a similar degree of objective measures of mucosal inflammation after surgery including endoscopic recurrence as compared to Caucasian patients. However, African-American race was significantly associated with clinical recurrence, suggesting the presence of ethnic variation in postoperative presentation in Crohn's disease.
BACKGROUND: Many patients with Crohn's disease will develop complications that require surgery. Recurrence after surgery is common. AIM: To assess racial differences in postoperative recurrence between African-Americans and Caucasians. METHODS: Medical records of Crohn's diseasepatients who underwent surgery (ileal, colonic, or ileocolonic resection) between June 2014 and June 2016 were reviewed. The primary endpoints were clinical and endoscopic remission at 6-12 months after a Crohn's disease surgery. Secondary outcomes included biological and histologic remission. Risks of recurrence were assessed by univariate, multivariate, and propensity score-matched analysis. RESULTS: Thirty-six African-American and 167 Caucasian patients with Crohn's disease were included for analysis. There was no difference in disease location, disease behaviour, type of surgery performed, and pre- or postoperative medication use between the two groups. The rate of endoscopic remission did not differ between African-American and Caucasian patients (50% vs 42%, P = 0.76), and race did not influence the risk of endoscopic recurrence on univariate, multivariate, or propensity score-matched analysis. The rate of clinical remission was significantly lower in African-American patients compared to Caucasian patients (36% vs. 63%, P = 0.008). African-American race was significantly associated with clinical recurrence on univariate (odds ratio (OR) 6.76, 95% CI 1.50-30.40; P = 0.01), multivariate (OR 5.02, 95% CI 1.60-15.80; P = 0.006), and propensity-matched analysis (68% vs. 32% in Caucasians, P = 0.005). Rates of biologic and histologic remission were similar between the two groups on all analyses. CONCLUSIONS: We found that African-American patients with Crohn's disease have a similar degree of objective measures of mucosal inflammation after surgery including endoscopic recurrence as compared to Caucasian patients. However, African-American race was significantly associated with clinical recurrence, suggesting the presence of ethnic variation in postoperative presentation in Crohn's disease.
Authors: Miguel Regueiro; Kevin E Kip; Wolfgang Schraut; Leonard Baidoo; Antonia R Sepulveda; Marilyn Pesci; Sandra El-Hachem; Janet Harrison; David Binion Journal: Inflamm Bowel Dis Date: 2011-01 Impact factor: 5.325
Authors: Constantinos Simillis; Takayuki Yamamoto; George E Reese; Satoru Umegae; Koichi Matsumoto; Ara W Darzi; Paris P Tekkis Journal: Am J Gastroenterol Date: 2007-09-25 Impact factor: 10.864
Authors: Elliot G Arsoniadis; Yen-Yi Ho; Genevieve B Melton; Robert D Madoff; Chap Le; Mary R Kwaan Journal: J Crohns Colitis Date: 2017-04-01 Impact factor: 9.071
Authors: Jacob E Ollech; Maya Aharoni-Golan; Roni Weisshof; Inessa Normatov; Abby R Sapp; Aditya Kalakonda; Amanda Israel; Laura R Glick; Theodore Karrison; Sushila R Dalal; Atsushi Sakuraba; Russell D Cohen; David T Rubin; Joel Pekow Journal: Gastrointest Endosc Date: 2019-02-06 Impact factor: 9.427