KMID : 1188320180120050544
|
|
Gut and Liver 2018 Volume.12 No. 5 p.544 ~ p.554
|
|
Association of Perianal Fistulas with Clinical Features and Prognosis of Crohn¡¯s Disease in Korea: Results from the CONNECT Study
|
|
Chun Jae-Young
Im Jong-Pil Kim Ji-Won Lee Kook-Lae Choi Chang-Hwan Kim Hyun-Soo Cheon Jae-Hee Ye Byong-Duk Kim Young-Ho Kim You-Sun Jeen Yoon-Tae Han Dong-Soo Kim Won-Ho Kim Joo-Sung
|
|
Abstract
|
|
|
Background/Aims: The disease course and factors associated with poor prognosis in Korean patients with Crohn¡¯s disease (CD) have not been fully determined. The aim of this study was to explore potential associations between the clinical characteristics and long-term outcomes of CD and perianal fistulas in a Korean population.
Methods: The retrospective Crohn¡¯s Disease Clinical Network and Cohort (CONNECT) study enrolled patients diagnosed with CD between July 1982 and December 2008 from 32 hospitals. Those followed for £¼12 months were excluded. Clinical outcomes were CD-related surgery and complications, including nonperianal fistulas, strictures, and intra-abdominal abscesses.
Results: The mean follow-up period was 8.77 years (range, 1.0 to 25.8 years). A total of 1,193 CD patients were enrolled, of whom 465 (39.0%) experienced perianal fistulas. Perianal fistulizing CD was significantly associated with younger age, male gender, CD diagnosed at primary care clinics, and ileocolonic involvement. Both nonperianal fistulas (p=0.034) and intra-abdominal abscesses (p=0.020) were significantly more common in CD patients with perianal fistulas than in those without perianal fistulas. The rates of complicated strictures and CD-related surgery were similar between the groups. Independently associated factors of nonperianal fistulas were perianal fistulas (p=0.015), female gender (p=0.048), CD diagnosed at referral hospital (p=0.003), and upper gastrointestinal (UGI) involvement (p=0.001). Furthermore, perianal fistulas (p=0.048) and UGI involvement (p=0.012) were independently associated with the risk of intra-abdominal abscesses.
Conclusions: Perianal fistulas predicted the development of nonperianal fistulas and intra-abdominal abscesses in Korean CD patients. Therefore, patients with perianal fistulizing CD should be carefully monitored for complicated fistulas or abscesses.
|
|
KEYWORD
|
|
Anal fistula, Crohn disease, Prognosis
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|