Yoshifumi Watanabe1, Norikatsu Miyoshi1, Shiki Fujino1, Hidekazu Takahashi1, Naotsugu Haraguchi1, Taishi Hata1, Chu Matsuda1, Hirofumi Yamamoto1, Yuichiro Doki1, Masaki Mori1, Tsunekazu Mizushima2,3. 1. Department of Gastroenterological Surgery, Graduate School of Medical, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. 2. Department of Gastroenterological Surgery, Graduate School of Medical, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. tmizushima@gesurg.med.osaka-u.ac.jp. 3. Department of Therapeutics for Inflammatory Bowel Diseases, Graduate School of Medical, Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan. tmizushima@gesurg.med.osaka-u.ac.jp.
Abstract
BACKGROUND: Intestinal failure is the most critical complication of Crohn's disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications. AIMS: The purpose of this study was to investigate the incidence and risk factors for intestinal failure in Crohn's disease. METHODS: We performed a retrospective analysis of Crohn's disease patients (162 cases) at Osaka University Hospital between January 2000 and December 2017. Kaplan-Meier analysis was used to investigate the cumulative incidence of intestinal failure. To identify the risk factors of intestinal failure, patient characteristics were analyzed by multivariate analysis, including disease classification, surgical history, medical treatment other than surgery, and cumulative inflammation was calculated using the average C-reactive protein value and disease duration. RESULTS: The cumulative incidence of intestinal failure 5, 10, and 15 years after Crohn's disease diagnosis was 2.6%, 3.4%, and 8.6%, respectively. Multivariate analysis identified the following as independent risk factors for intestinal failure in Crohn's disease: residual small intestinal length < 200 cm (odds ratio 7.51, 95% confidence interval 2.14-29.96), non-use of anti-tumor necrosis factor-alpha therapy (3.34, 1.22-10.74), and cumulative inflammation (1.01, 1.001-1.038). We created a new predictive nomogram consisting of these risk factors. CONCLUSIONS: Intestinal failure occasionally occurred during long-term treatment of Crohn's disease. Cumulative inflammation for the first time, in addition to short residual small intestinal length and non-use of anti-tumor necrosis factor-alpha therapy, was shown to be potential risk factors for intestinal failure in Crohn's disease.
BACKGROUND:Intestinal failure is the most critical complication of Crohn's disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications. AIMS: The purpose of this study was to investigate the incidence and risk factors for intestinal failure in Crohn's disease. METHODS: We performed a retrospective analysis of Crohn's diseasepatients (162 cases) at Osaka University Hospital between January 2000 and December 2017. Kaplan-Meier analysis was used to investigate the cumulative incidence of intestinal failure. To identify the risk factors of intestinal failure, patient characteristics were analyzed by multivariate analysis, including disease classification, surgical history, medical treatment other than surgery, and cumulative inflammation was calculated using the average C-reactive protein value and disease duration. RESULTS: The cumulative incidence of intestinal failure 5, 10, and 15 years after Crohn's disease diagnosis was 2.6%, 3.4%, and 8.6%, respectively. Multivariate analysis identified the following as independent risk factors for intestinal failure in Crohn's disease: residual small intestinal length < 200 cm (odds ratio 7.51, 95% confidence interval 2.14-29.96), non-use of anti-tumor necrosis factor-alpha therapy (3.34, 1.22-10.74), and cumulative inflammation (1.01, 1.001-1.038). We created a new predictive nomogram consisting of these risk factors. CONCLUSIONS:Intestinal failure occasionally occurred during long-term treatment of Crohn's disease. Cumulative inflammation for the first time, in addition to short residual small intestinal length and non-use of anti-tumor necrosis factor-alpha therapy, was shown to be potential risk factors for intestinal failure in Crohn's disease.
Authors: K Elriz; V Palascak-Juif; F Joly; D Seguy; P Beau; C Chambrier; M Boncompain; E Fontaine; D Laharie; G Savoye; E Lerebours Journal: Aliment Pharmacol Ther Date: 2011-08-16 Impact factor: 8.171
Authors: Aysegül Aksan; Karima Farrag; Irina Blumenstein; Oliver Schröder; Axel U Dignass; Jürgen Stein Journal: World J Gastroenterol Date: 2021-06-28 Impact factor: 5.742
Authors: Zeinab Bakhshi; Siddhant Yadav; Bradley R Salonen; Sara L Bonnes; Jithinraj Edakkanambeth Varayil; William Scott Harmsen; Ryan T Hurt; William J Tremaine; Edward V Loftus Journal: Crohns Colitis 360 Date: 2020-10-21