1. Reduction in surgical stoma rates in Crohn's disease: a population-based time trend analysis.
- Author
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Ma C, Almutairdi A, Tanyingoh D, Seow CH, Novak KL, Lu C, Panaccione R, Kaplan GG, and Kotze PG
- Subjects
- Adult, Canada epidemiology, Crohn Disease epidemiology, Databases, Factual, Female, Humans, Incidence, Male, Middle Aged, Prevalence, Time Factors, Crohn Disease surgery, Emergencies epidemiology, Population Surveillance, Surgical Stomas trends
- Abstract
Aim: Trends in surgical rates for Crohn's disease (CD) in the biological era are controversial. We aim to assess modern trends in the formation rates of surgical stomas., Method: Population-based surveillance in the Calgary Health Zone (CHZ), Canada, was conducted between 1 April 2002 and 31 March 2011, using the Discharge Abstract Database to identify adult patients with CD admitted to hospital and treated with surgical stoma formation (n = 545). Annual stoma incidence was calculated by dividing the number of incident stomas by the prevalence of CD in the CHZ. Time trend analysis of the stoma-formation rate was performed, expressed as annual percentage change (APC) with 95% CI. Stoma-formation rates were stratified according to procedure (emergency vs elective) and duration of stoma [temporary (reversed within 2 years of formation) vs permanent]., Results: The overall rate of stoma formation between 2002 and 2011 showed a downwards trend, of a mean of 5.2% (95% CI: -8.5 to -1.8) per year, from a rate of 2.30 stomas/100 person-years (PY) in 2002 to 1.51 stomas/100 PY in 2011. The rate of emergency stoma formation decreased significantly from 2002 to 2011 (mean APC = -9.4%; 95% CI: -15.6 to -2.8), while the rate of elective ostomies essentially showed no change (mean APC = -0.9%; 95% CI: -5.3 to 3.8). The rate of temporary stoma formation decreased significantly, by 4.6% (95% CI: -7.3 to -1.8) per year, while permanent stoma formation was stable (APC = 1.0%; 95% CI: -4.0 to +6.3)., Conclusion: A reduction in the overall rate of stoma formation in CD has been driven by fewer emergency stomas, although rates of permanent stoma have remained stable., (Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland.)
- Published
- 2019
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