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Influence of age at diagnosis on the clinical characteristics of Crohn's disease in Korea: Results from the CONNECT study
Author(s) -
Hwang Sung Wook,
Kim Jee Hyun,
Im Jong Pil,
Ye Byong Duk,
Koo Hoon Sup,
Huh Kyu Chan,
Cheon Jae Hee,
Kim You Sun,
Kim Young Ho,
Han Dong Soo,
Kim Won Ho,
Kim Joo Sung
Publication year - 2017
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.13775
Subject(s) - medicine , thiopurine methyltransferase , hazard ratio , confidence interval , gastroenterology , crohn's disease , age groups , cohort , disease , age of onset , young adult , risk factor , cohort study , pediatrics , surgery , inflammatory bowel disease , demography , sociology
Background and Aim The present study evaluated the clinical characteristics of Korean patients with Crohn's disease (CD) according to their age at diagnosis in a nationwide multicenter cohort study. Methods A total of 1224 patients diagnosed with CD between 1982 and 2008 in 32 hospitals were included, and age at diagnosis was categorized as ≤ 16 (G1), 17–40 (G2), 41–59 (G3) and ≥ 60 (G4) years old. The baseline characteristics, medication, and intestinal resection were compared according to the age at diagnosis. Results The number of patients in each age group was 155 (G1; 12.7%), 919 (G2; 75.1%), 120 (G3; 9.8%), and 30 (G4; 2.5%). The frequencies of ileocolonic disease in the late adult onset and elderly onset groups were lower than those in the other groups ( P < 0.001). The cumulative probabilities of thiopurine and anti‐tumor necrosis factor use in late adult onset and elderly onset groups were significantly reduced compared with those of the other groups ( P < 0.01). However, the risk of the first intestinal resection was not different among the age groups. The ileal location (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.11–2.27), complicated behavior (HR: 3.35; 95% CI: 2.63–4.27), and early thiopurine use (HR: 0.27; 95% CI: 0.17–0.43) were associated with the first intestinal resection, whereas the age at diagnosis was not a risk factor. Conclusions Elderly onset CD may be related to favorable outcomes in Korea. Thus, the heterogeneity of this disease should be considered when developing a tailored strategy for the treatment of CD.