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Incidence and Outcomes of Perianal Disease in an Asian Population with Crohn's Disease: A Nationwide Population-Based Study.
Digestive Diseases and Sciences ( IF 3.1 ) Pub Date : null , DOI: 10.1007/s10620-019-05819-9
Eun Mi Song 1 , Ho-Su Lee 2 , Ye-Jee Kim 3 , Eun Hye Oh 1 , Nam Seok Ham 1 , Jeongseok Kim 1 , Sung Wook Hwang 1 , Sang Hyoung Park 1 , Dong-Hoon Yang 1 , Byong Duk Ye 1 , Jeong-Sik Byeon 1 , Seung-Jae Myung 1 , Jong Lyul Lee 4 , Yong Sik Yoon 4 , Chang Sik Yu 4 , Suk-Kyun Yang 1
Affiliation  

BACKGROUND Little is known about the natural history of perianal fistulas in Asian populations with Crohn's disease (CD). AIMS We investigated the incidence and outcomes of perianal CD (pCD) in Korean CD patients. METHODS A nationwide population-based cohort of 6265 CD patients diagnosed in 2010-2014 was analyzed to investigate the incidence and outcomes of pCD. The results were validated in a hospital-based cohort of 2923 CD patients diagnosed in 1981-2015. Factors associated with pCD development were analyzed. The incidence and outcomes of pCD were compared between the prebiologic and biologic eras. RESULTS pCD occurred in 39.2% of the population-based cohort and 56.1% of the hospital-based cohort during the median follow-up of 4.2 and 8.5 years, respectively. The cumulative incidence of pCD was 40.0% at 5 years after CD diagnosis in the population-based cohort and 62.5% at 20 years in the hospital-based cohort. In multivariate analysis, pCD development was positively associated with male sex, younger age and colonic involvement at diagnosis, early diagnosis, and CD diagnosis in the prebiologic era. The cumulative probability of proctectomy at 10, 20, and 30 years after pCD diagnosis was 2.9%, 12.2%, and 16.2%, respectively. The cumulative incidence of pCD occurring after CD diagnosis and the cumulative probability of proctectomy were significantly lower in the biologic era than in the prebiologic era (p < 0.001 and p = 0.03, respectively). CONCLUSIONS Compared with Western patients with CD, Korean patients show a high incidence of pCD but have a low probability of proctectomy, suggesting the favorable course of pCD.

中文翻译:

亚洲克罗恩病人群中肛周疾病的发病率和结局:基于全国的人群研究。

背景技术关于患有克罗恩氏病(CD)的亚洲人群的肛周瘘的自然史知之甚少。目的我们调查了韩国CD患者肛周CD(pCD)的发生率和结局。方法分析2010-2014年在全国范围内诊断的6265例CD患者的队列,以调查pCD的发生率和结局。1981-2015年在医院诊断的2923名CD患者中验证了结果。分析了与pCD发育相关的因素。比较了前生物学时代和生物学时代之间pCD的发生率和结局。结果在中位随访时间为4.2年和8.5年的人群中,pCD分别发生于39.2%的人群和56.1%的医院人群。pCD的累积发生率为40。在以人群为基础的队列中,CD诊断后5年为0%,在以医院为基础的队列中20年时为62.5%。在多变量分析中,在前生物学时代,pCD的发展与男性,年轻的年龄以及在诊断,早期诊断和CD诊断时的结肠受累呈正相关。pCD诊断后10年,20年和30年直肠切除术的累积概率分别为2.9%,12.2%和16.2%。在生物诊断时代,CD诊断后发生的pCD累积发生率和直肠切除术的累积概率显着低于生物学前时期(分别为p <0.001和p = 0.03)。结论与西方的CD患者相比,韩国患者的pCD发生率高,但直肠切除术的可能性低,提示pCD病程良好。
更新日期:2020-03-19
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