Factors associated with surgical resection in patients with Crohn’s disease: long-term evaluation

Ferreira, Sandro da Costa; Aprile, Lílian Rose Otoboni; Parra, Rogério Serafim; Feitosa, Marley Ribeiro; Castro, Patrícia Picardi Morais de; Perdoná, Gleici de Castro da Silva; Feres, Omar; Rocha, José Joaquim Ribeiro da; Troncon, Luiz Ernesto de Almeida

doi:10.1590/acb391924

Sandro da Costa Ferreira ^* Corresponding author: scferreira@hcrp.usp.br

medical doctors and clinicals.

Conception and design

Acquisition of data

Analysis and interpretation of data

Manuscript preparation

Manuscript writing

Universidade de São Paulo – Medical School – Department of Medicine – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0001-7698-6599

Lílian Rose Otoboni Aprile

medical doctors and clinicals.

Acquisition of data

Universidade de São Paulo – Medical School – Department of Medicine – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0002-4575-4346

Rogério Serafim Parra

medical doctors and surgeons.

Analysis and interpretation of data

Manuscript preparation

Manuscript writing

Universidade de São Paulo – Medical School – Department of Surgery and Anatomy – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0002-5566-9284

Marley Ribeiro Feitosa

medical doctors and surgeons.

Analysis and interpretation of data

Manuscript preparation

Universidade de São Paulo – Medical School – Department of Surgery and Anatomy – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0002-4440-2023

Patrícia Picardi Morais de Castro

Statistics.

Statistics analysis

Universidade de São Paulo – Medical School – Department of Social Medicine – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0002-4796-139X

Gleici de Castro da Silva Perdoná

Statistics.

Statistics analysis

Universidade de São Paulo – Medical School – Department of Social Medicine – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0003-0479-5499

Omar Feres

PhDs.

Substantive scientific and intellectual contributions to the study

Universidade de São Paulo – Medical School – Department of Surgery and Anatomy – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0003-3593-0526

José Joaquim Ribeiro da Rocha

PhDs.

Substantive scientific and intellectual contributions to the study

Universidade de São Paulo – Medical School – Department of Surgery and Anatomy – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0001-7118-0545

Luiz Ernesto de Almeida Troncon

PhDs.

Substantive scientific and intellectual contributions to the study

Conception and design

Critical revision

Universidade de São Paulo – Medical School – Department of Medicine – Ribeirão Preto (SP), Brazil.

http://orcid.org/0000-0002-8599-2410

Corresponding author: scferreira@hcrp.usp.br

Section editor: Gaspar Lopes Filho https://orcid.org/0000-0002-9344-6479

Conflict of interest

Nothing to declare.

Variable	CD patients (n = 295)
Age (mean ± standard deviation)	43.88 ± 14.35
	n	%
Gender
Male	157	53.2
Female	138	46.8
Skin color
White	248	84.1
Mixed race	27	9.1
Black	20	6.8
Age at the time of inflammatory bowel disease diagnosis (years old)^† † Involvement of other parts of the body, such as joints, eyes, skin, liver and bile ducts, in patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease).
< 16	31	10.5
16–40	203	68.8
> 40	61	20.7
Location of Crohn’s disease^† † Involvement of other parts of the body, such as joints, eyes, skin, liver and bile ducts, in patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease).
Ileal	80	27.1
Colonic	34	11.5
Ileo-colonic	174	59.0
Upper gastrointestinal tract	7	2.4
Behavior of Crohn’s disease^† † Involvement of other parts of the body, such as joints, eyes, skin, liver and bile ducts, in patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease).
Inflammatory	61	20.7
Stenosing	110	37.3
Fistulizing	124	42.0
Perianal disease	99	33.6
Smoking
Yes	89	30.2
No	206	69.8
Extraintestinal manifestation^† † Involvement of other parts of the body, such as joints, eyes, skin, liver and bile ducts, in patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease).
Yes	33	11.2
No	262	88.8
Surgical resection
Yes	155	52.5
No	140	47.5

Characteristics and clinical variables	Surgical resection				p-value
Characteristics and clinical variables	Present (n = 155)		Absent (n = 140)		p-value
Duration of Crohn’s disease (mean ± standard deviation)	16.36 ± 9.58		10.54 ± 6.36		< 0.001
	n	%	n	٪
Gender					0.420
Male	79	51	78	55.7
Female	76	49	62	44.3
Smoking					< 0.001
Yes	1	3.9	28	14.1
No	25	96.1	179	85.9
Initial use of biologicals					< 0.001
Yes	23	14.8	48	34.3
No	132	85.2	92	65.7
Age at the time of inflammatory bowel disease diagnosis (years old)^† † Involvement of other parts of the body, such as joints, eyes, skin, liver and bile ducts, in patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease).					0.680
< 16	14	9.1	17	12.1
16–40	109	70.3	94	67.1
> 40	32	20.6	29	20.8
Location of Crohn’s disease^† † Involvement of other parts of the body, such as joints, eyes, skin, liver and bile ducts, in patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease).
Ileal	34	21.9	46	32.9
Colonic	6	3.9	28	20	0.001
Ileo-colonic	109	70.3	65	46.4	0.003
Upper gastrointestinal tract	6	3.9	1	0.7
Behavior of Crohn’s disease^† † Involvement of other parts of the body, such as joints, eyes, skin, liver and bile ducts, in patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease).
Inflammatory	4	2.6	57	40.7
Stenosing	81	52.3	29	20.7	< 0.001
Fistulizing	70	45.2	54	38.6	< 0.001
Perianal disease	48	31	51	36.4	0.32
Extraintestinal manifestation^† † Involvement of other parts of the body, such as joints, eyes, skin, liver and bile ducts, in patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease).					0.82
Yes	18	11.6	15	10.7
No	137	88.4	125	89.3

Clinical variables	Univariate analyses			Multivariate analyses
Clinical variables	OR	95%CI	p-value	OR	95%CI	p-value
Smoking	3	1.76–5.12	< 0.001	3.30	1.67–6.51	0.001
Initial use of biologicals	0.33	0.19–0.59	< 0.001	-	-	-
Longer diagnosis of Crohn’s disease	-	-	< 0.001	1.08	1.04–1.12	< 0.001
Ileo-colonic location	2.77	1.32–3.89	0.003	1.88	0.99–3.83	0.008
Colonic location	0.29	0.11–0.78	0.01	-	-	-
Stenosing phenotype	39.80	13.26–119.43	< 0.001	39.79	10.07–106.82	< 0.001
Fistulizing phenotype	18.47	6.31–54.08	< 0.001	16.48	5.18–52.44	< 0.001

[1] Corresponding author: scferreira@hcrp.usp.br

Brasil

Brasil

Factors associated with surgical resection in patients with Crohn’s disease: long-term evaluation

ABSTRACT

Purpose:

Methods:

Results:

Conclusions: