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Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn's Disease.

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.

journal_name

Dig Dis Sci

journal_title

Digestive diseases and sciences

authors

Watanabe Y,Miyoshi N,Fujino S,Takahashi H,Haraguchi N,Hata T,Matsuda C,Yamamoto H,Doki Y,Mori M,Mizushima T

doi

10.1007/s10620-019-05553-2

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

2280-2285

issue

8

eissn

0163-2116

issn

1573-2568

pii

10.1007/s10620-019-05553-2

journal_volume

64

pub_type

杂志文章

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