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Clinical features and predictors of clinical outcomes in K orean patients with C rohn's disease: A K orean A ssociation for the S tudy of I ntestinal D iseases multicenter study
Author(s) -
Moon Chang Mo,
Park Dong Il,
Kim Eun Ran,
Kim YoungHo,
Lee Chang Kyun,
Lee SuckHo,
Kim Jae Hak,
Huh KyuChan,
Jung SungAe,
Yoon Soon Man,
Song Hyun Joo,
Jang Hyun Joo,
Kim You Sun,
Lee KangMoon,
Shin Jeong Eun
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12369
Subject(s) - medicine , hazard ratio , infliximab , gastroenterology , disease , retrospective cohort study , cohort , population , confidence interval , environmental health
Background and Aim Although differences in genetic susceptibility and the clinical features of C rohn's disease ( CD ) have been reported between A sian and C aucasian patients, the disease course and predictors of CD in A sians remains poorly defined. The study therefore aimed to investigate factors predictive of the clinical outcomes of patients with CD in a K orean population. Methods This retrospective multicenter cohort study included 728 K orean CD patients from 13 university hospitals. The first CD ‐related surgery or need for immunosuppressive or biological agents were regarded as the clinical outcomes of interest. Results A total of 126 (17.3%) CD patients underwent CD ‐related surgery, while 473 (65.0%) and 196 (26.9%) were prescribed thiopurine drugs and infliximab, respectively. Multivariate C ox regression analysis identified current (hazard ratio [ HR ] = 1.86; P = 0.018) and former smoking habits ( HR = 1.78; P = 0.049), stricturing ( HR = 2.24; P < 0.001), and penetrating disease behavior at diagnosis ( HR = 3.07; P < 0.001) as independent predictors associated with the first CD ‐related surgery. With respect to immunosuppressive and biological agents, younger age (< 40 years) ( HR = 2.17; P < 0.001 and HR = 2.10; P = 0.006, respectively), ileal involvement ( HR = 1.36; P = 0.035 and HR = 2.17; P = 0.006, respectively), and perianal disease ( HR = 1.42; P = 0.001 and HR = 1.38; P = 0.038, respectively) at diagnosis were significant predictors for the need of these medications. Conclusions In K orean patients with CD , stricturing, penetrating disease behavior, and smoking habits at the time of diagnosis are independent predictors for CD ‐related surgery. It was also identified that younger age (< 40 years), ileal involvement, and perianal disease at diagnosis are predictive of a need for immunosuppressive or biological agents.