1. Incidence of and Risk Factors for Free Bowel Perforation in Patients with Crohn's Disease.
- Author
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Kim, Jong, Lee, Ho-Su, Ye, Byong, Yang, Suk-Kyun, Hwang, Sung, Park, Sang, Yang, Dong-Hoon, Kim, Kyung-Jo, Byeon, Jeong-Sik, Myung, Seung-Jae, Yoon, Yong, Yu, Chang, Kim, Jin-Ho, Kim, Jong Wook, Ye, Byong Duk, Hwang, Sung Wook, Park, Sang Hyoung, Yoon, Yong Sik, and Yu, Chang Sik
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INTESTINAL perforation , *CROHN'S disease , *MEDICAL records , *MEDICAL centers , *LOGISTIC regression analysis , *SURGICAL emergencies , *PATIENTS , *CROHN'S disease diagnosis , *GASTROINTESTINAL agents , *COLON diseases , *ILEUM diseases , *LONGITUDINAL method , *REOPERATION , *TUMOR necrosis factors , *JEJUNUM diseases , *DISEASE incidence , *RETROSPECTIVE studies , *CASE-control method , *CHEMICAL inhibitors , *DISEASE complications , *THERAPEUTICS - Abstract
Background: Incidence of and risk factors for intestinal free perforation (FP) in patients with Crohn's disease (CD) are not established.Aim: To establish rate of and risk factors for FP in a large cohort of CD patients.Methods: Medical records of CD patients who visited Asan Medical Center from June 1989 to December 2012 were reviewed. After matching the FP patients to controls (1:4) by gender, year, and age at CD diagnosis, and disease location, their clinical characteristics were compared using conditional logistic regression analysis.Results: Among 2043 patients who were included in our study cohort, 44 patients (2.15%) developed FP over a median follow-up period of 79.8 months (interquartile range 37.3-124.6), with an incidence of 3.18 per 1000 person-years [95% confidence interval (CI) 2.37-4.28]. All 44 patients underwent emergency surgery, and eight patients underwent reoperation within 12 months (8/44, 18.2%). Multivariable-adjusted analysis revealed that anti-TNF therapy [odds ratio (OR), 3.73; 95% CI 1.19-11.69; p = 0.024] was associated with an increased risk of FP.Conclusions: The incidence of FP in a large cohort of Korean CD patients was 2.15%, which was similar to that in Western reports. Anti-TNF therapy could be risk factors for FP. [ABSTRACT FROM AUTHOR]- Published
- 2017
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