Abstract:
GOALS:We investigated the prognosis of Crohn's disease (CD) in Korean patients with jejunal involvement. BACKGROUND:Although jejunal involvement is considered a poor prognostic factor of CD in whites, it has never been validated in Asian populations. METHODS:We retrospectively reviewed the medical records of 1403 Korean CD patients (median age at diagnosis, 23 years; male patients, 72.3%; median follow-up duration, 65 mo). Probabilities of medication use, surgery, and hospitalization were analyzed by a Cox proportional hazards model and a Poisson regression model. RESULTS:Jejunal involvement was observed in 198 of 1403 (14.1%) patients at diagnosis. There were more ileal location (28.3% vs. 20.6%, P<0.001) and stricturing behavior (16.7% vs. 9.4%, P=0.001) in the jejunal group than in the non-jejunal group. In univariate analyses, the cumulative probabilities of treatment with corticosteroids (P=0.014) and thiopurines (P=0.008), the first major surgery (P=0.021), and the first hospitalization (P=0.015) were significantly higher in the jejunal than in the non-jejunal group. In multivariate analyses, jejunal involvement was independently associated with the more common use of corticosteroids [hazard ratio, 1.24; 95% confidence interval (CI), 1.02-1.50] and thiopurines (hazard ratio, 1.26; 95% CI, 1.06-1.49), higher incidence rates of strictureplasties [relative risk (RR), 2.52; 95% CI, 1.60-3.96] and hospitalizations (RR, 1.29; 95% CI, 1.14-1.47), and longer hospitalization duration (RR, 1.30; 95% CI, 1.25-1.34). CONCLUSIONS:Korean CD patients are more likely to have jejunal involvement than western patients. Jejunal involvement is one of the poor prognostic factors in Korean CD patients, as it is in westerners.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Park SK,Yang SK,Park SH,Park SH,Kim JW,Yang DH,Jung KW,Kim KJ,Ye BD,Byeon JS,Myung SJ,Yu CS,Kim JHdoi
10.1097/MCG.0b013e3182705f9esubject
Has Abstractpub_date
2013-05-01 00:00:00pages
400-8issue
5eissn
0192-0790issn
1539-2031journal_volume
47pub_type
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