A Novel Predictive Nomogram for Early Endoscopic Recurrence after Intestinal Resection for Crohn's Disease.

Abstract

BACKGROUND/AIMS:

Endoscopic recurrence (ER) after intestinal resection for Crohn's disease (CD) precedes the clinical recurrence, and the severity of ER correlates with the severity of the subsequent clinical recurrence. This study aimed to identify risk factors related to early ER after intestinal resection for CD and to create a prediction model.

METHODS:

The patients who underwent intestinal resection for CD between April 2008 and April 2017 and took endoscopic evaluation between 6 and 12 months after surgery were retrospectively analyzed.

RESULTS:

A total of 15 out of 52 (29%) patients developed early ER. A univariate analysis demonstrated that early ER was significantly correlated with history of prior intestinal resections for CD (p = 0.005), low preoperative albumin levels (p = 0.035), and excessive perioperative inflammation (i.e., high C-reactive protein levels in both preoperative and postoperative periods; p = 0.034). Based on these clinical factors, a nomogram for predicting early ER was created with the area under the curve 0.808.

CONCLUSION:

We developed a novel predictive nomogram for early ER after intestinal resection for CD. This prediction model might assist clinicians in managing patients with CD after an intestinal resection. Additional validation studies are currently being developed.

• Authors: Atsuyo Ikeda, Norikatsu Miyoshi, Shiki Fujino, Hideki Iijima, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Yuichiro Doki, Masaki Mori, Tsunekazu Mizushima
• Journal: Digestion (Digestion) Vol. 100 Issue 4 Pg. 269-276 ( 2019) ISSN: 1421-9867 [Electronic] Switzerland
• PMID: 30602165 (Publication Type: Journal Article)
• Copyright: © 2019 S. Karger AG, Basel.

Topics

• Adult
• Aged
• Colon (diagnostic imaging, surgery)
• Crohn Disease (diagnosis, pathology, surgery)
• Endoscopy, Gastrointestinal
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Ileum (diagnostic imaging, pathology, surgery)
• Male
• Middle Aged
• Nomograms
• Patient Selection
• Recurrence
• Retrospective Studies
• Risk Factors
• Treatment Outcome
• Young Adult