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Evolution of clinical behaviour in Crohn's disease: predictive factors of penetrating complications
Crohn's disease is a heterogeneous entity. The Vienna Classification defines three different clinical patterns: ‘non-stricturing, non-penetrating’, ‘stricturing’ and ‘penetrating’. Aim of this study was to assess the change in clinical behaviour over time and to evaluate whether an evolution to...
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| Published in: | Digestive and liver disease 2005-04, Vol.37 (4), p.247-253 |
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| container_title | Digestive and liver disease |
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| creator | Papi, C. Festa, V. Fagnani, C. Stazi, A. Antonelli, G. Moretti, A. Koch, M. Capurso, L. |
| description | Crohn's disease is a heterogeneous entity. The Vienna Classification defines three different clinical patterns: ‘non-stricturing, non-penetrating’, ‘stricturing’ and ‘penetrating’. Aim of this study was to assess the change in clinical behaviour over time and to evaluate whether an evolution towards penetrating complications can be predicted.
A total of 139 patients with non-penetrating behaviour at the time of diagnosis were included. The mean follow-up was 4.84 years (range 1–23.2 years). The clinical behaviour, according to the Vienna Criteria, was assessed at the diagnosis and at the end of follow up. Statistical analysis was performed by means of the Kaplan–Meier method and standard logistic regression analysis.
The cumulative probability of a change in clinical behaviour was 22, 38 and 63% at 3, 6 and 12 years, respectively, and the cumulative probability of developing penetrating complications was 22, 33 and 55% at 3, 6 and 12 years, respectively. Young age at diagnosis ( |
| doi_str_mv | 10.1016/j.dld.2004.10.012 |
| format | article |
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A total of 139 patients with non-penetrating behaviour at the time of diagnosis were included. The mean follow-up was 4.84 years (range 1–23.2 years). The clinical behaviour, according to the Vienna Criteria, was assessed at the diagnosis and at the end of follow up. Statistical analysis was performed by means of the Kaplan–Meier method and standard logistic regression analysis.
The cumulative probability of a change in clinical behaviour was 22, 38 and 63% at 3, 6 and 12 years, respectively, and the cumulative probability of developing penetrating complications was 22, 33 and 55% at 3, 6 and 12 years, respectively. Young age at diagnosis (<40 years) and a stricturing behaviour are independent risk factors of developing major penetrating complications (internal fistula, mass or abscess): OR
=
6.0, 95% CI 1.1–30.5; OR
=
4.0, 95% CI 1.5–10.9, respectively, but not perianal disease.
The behavioural classification of Crohn's disease is a dynamic model in which each status should be considered as not fixed but evolutive. Perianal disease should be considered a distinct pattern of penetrating behaviour.</description><identifier>ISSN: 1590-8658</identifier><identifier>EISSN: 1878-3562</identifier><identifier>DOI: 10.1016/j.dld.2004.10.012</identifier><identifier>PMID: 15788208</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Age Factors ; Crohn Disease - complications ; Crohn Disease - pathology ; Crohn's disease ; Disease Progression ; Female ; Fistulising Crohn's disease ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Prognosis ; Risk Factors ; Smoking ; Survival Analysis ; Time Factors ; Vienna Classification</subject><ispartof>Digestive and liver disease, 2005-04, Vol.37 (4), p.247-253</ispartof><rights>2004 Editrice Gastroenterologica Italiana S.r.l.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c351t-f416145f62a9185ef62b732c115bee0bf6594c3e7a3884c6b1b64619885ee9a23</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15788208$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Papi, C.</creatorcontrib><creatorcontrib>Festa, V.</creatorcontrib><creatorcontrib>Fagnani, C.</creatorcontrib><creatorcontrib>Stazi, A.</creatorcontrib><creatorcontrib>Antonelli, G.</creatorcontrib><creatorcontrib>Moretti, A.</creatorcontrib><creatorcontrib>Koch, M.</creatorcontrib><creatorcontrib>Capurso, L.</creatorcontrib><title>Evolution of clinical behaviour in Crohn's disease: predictive factors of penetrating complications</title><title>Digestive and liver disease</title><addtitle>Dig Liver Dis</addtitle><description>Crohn's disease is a heterogeneous entity. The Vienna Classification defines three different clinical patterns: ‘non-stricturing, non-penetrating’, ‘stricturing’ and ‘penetrating’. Aim of this study was to assess the change in clinical behaviour over time and to evaluate whether an evolution towards penetrating complications can be predicted.
A total of 139 patients with non-penetrating behaviour at the time of diagnosis were included. The mean follow-up was 4.84 years (range 1–23.2 years). The clinical behaviour, according to the Vienna Criteria, was assessed at the diagnosis and at the end of follow up. Statistical analysis was performed by means of the Kaplan–Meier method and standard logistic regression analysis.
The cumulative probability of a change in clinical behaviour was 22, 38 and 63% at 3, 6 and 12 years, respectively, and the cumulative probability of developing penetrating complications was 22, 33 and 55% at 3, 6 and 12 years, respectively. Young age at diagnosis (<40 years) and a stricturing behaviour are independent risk factors of developing major penetrating complications (internal fistula, mass or abscess): OR
=
6.0, 95% CI 1.1–30.5; OR
=
4.0, 95% CI 1.5–10.9, respectively, but not perianal disease.
The behavioural classification of Crohn's disease is a dynamic model in which each status should be considered as not fixed but evolutive. Perianal disease should be considered a distinct pattern of penetrating behaviour.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Crohn Disease - complications</subject><subject>Crohn Disease - pathology</subject><subject>Crohn's disease</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Fistulising Crohn's disease</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Smoking</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Vienna Classification</subject><issn>1590-8658</issn><issn>1878-3562</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LxDAQhoMo7vrxA7xITnrqmmmbNNWTLH7Bghc9hzSdulm6TU3aBf-9KbvgzdPMhPd9IA8hV8AWwEDcbRZ1Wy9SxvJ4LxikR2QOspBJxkV6HHdeskQKLmfkLIQNYykIzk7JDHghZcrknJinnWvHwbqOuoaa1nbW6JZWuNY760ZPbUeX3q2720BrG1AHvKe9x9qawe6QNtoMzoep3GOHg9eD7b6ocdu-jaQJHC7ISaPbgJeHeU4-n58-lq_J6v3lbfm4SkzGYUiaHATkvBGpLkFyjEtVZKkB4BUiqxrBy9xkWOhMytyICiqRCyhlzGKp0-yc3Oy5vXffI4ZBbW0w2La6QzcGJQrOGStEDMI-aLwLwWOjem-32v8oYGoyqzYqmlWT2ekpmo2d6wN8rLZY_zUOKmPgYR_A-MWdRa-CsdiZqMqjGVTt7D_4X5jpif8</recordid><startdate>20050401</startdate><enddate>20050401</enddate><creator>Papi, C.</creator><creator>Festa, V.</creator><creator>Fagnani, C.</creator><creator>Stazi, A.</creator><creator>Antonelli, G.</creator><creator>Moretti, A.</creator><creator>Koch, M.</creator><creator>Capurso, L.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050401</creationdate><title>Evolution of clinical behaviour in Crohn's disease: predictive factors of penetrating complications</title><author>Papi, C. ; Festa, V. ; Fagnani, C. ; Stazi, A. ; Antonelli, G. ; Moretti, A. ; Koch, M. ; Capurso, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-f416145f62a9185ef62b732c115bee0bf6594c3e7a3884c6b1b64619885ee9a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Crohn Disease - complications</topic><topic>Crohn Disease - pathology</topic><topic>Crohn's disease</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Fistulising Crohn's disease</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Smoking</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Vienna Classification</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Papi, C.</creatorcontrib><creatorcontrib>Festa, V.</creatorcontrib><creatorcontrib>Fagnani, C.</creatorcontrib><creatorcontrib>Stazi, A.</creatorcontrib><creatorcontrib>Antonelli, G.</creatorcontrib><creatorcontrib>Moretti, A.</creatorcontrib><creatorcontrib>Koch, M.</creatorcontrib><creatorcontrib>Capurso, L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive and liver disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Papi, C.</au><au>Festa, V.</au><au>Fagnani, C.</au><au>Stazi, A.</au><au>Antonelli, G.</au><au>Moretti, A.</au><au>Koch, M.</au><au>Capurso, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolution of clinical behaviour in Crohn's disease: predictive factors of penetrating complications</atitle><jtitle>Digestive and liver disease</jtitle><addtitle>Dig Liver Dis</addtitle><date>2005-04-01</date><risdate>2005</risdate><volume>37</volume><issue>4</issue><spage>247</spage><epage>253</epage><pages>247-253</pages><issn>1590-8658</issn><eissn>1878-3562</eissn><abstract>Crohn's disease is a heterogeneous entity. The Vienna Classification defines three different clinical patterns: ‘non-stricturing, non-penetrating’, ‘stricturing’ and ‘penetrating’. Aim of this study was to assess the change in clinical behaviour over time and to evaluate whether an evolution towards penetrating complications can be predicted.
A total of 139 patients with non-penetrating behaviour at the time of diagnosis were included. The mean follow-up was 4.84 years (range 1–23.2 years). The clinical behaviour, according to the Vienna Criteria, was assessed at the diagnosis and at the end of follow up. Statistical analysis was performed by means of the Kaplan–Meier method and standard logistic regression analysis.
The cumulative probability of a change in clinical behaviour was 22, 38 and 63% at 3, 6 and 12 years, respectively, and the cumulative probability of developing penetrating complications was 22, 33 and 55% at 3, 6 and 12 years, respectively. Young age at diagnosis (<40 years) and a stricturing behaviour are independent risk factors of developing major penetrating complications (internal fistula, mass or abscess): OR
=
6.0, 95% CI 1.1–30.5; OR
=
4.0, 95% CI 1.5–10.9, respectively, but not perianal disease.
The behavioural classification of Crohn's disease is a dynamic model in which each status should be considered as not fixed but evolutive. Perianal disease should be considered a distinct pattern of penetrating behaviour.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>15788208</pmid><doi>10.1016/j.dld.2004.10.012</doi><tpages>7</tpages></addata></record> |
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| source | ScienceDirect Freedom Collection |
| subjects | Adult Age Factors Crohn Disease - complications Crohn Disease - pathology Crohn's disease Disease Progression Female Fistulising Crohn's disease Follow-Up Studies Humans Logistic Models Male Prognosis Risk Factors Smoking Survival Analysis Time Factors Vienna Classification |
| title | Evolution of clinical behaviour in Crohn's disease: predictive factors of penetrating complications |
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