Analyses of Changing Disease Patterns and Factors Related to Disease Outcomes in Patients with Crohn’s Disease after 7 Years of Follow-up: A Single-center Retrospective Study

Background: The clinical spectrum and disease course of Crohn’s disease (CD) are heterogeneous and difficult to predict based on initial presentation. Aim: To analyze the long-term disease course and factors leading to poor prognosis of the disease.Methods: In total, 112 patients with CD who were initially diagnosed or treated at our institution were included. We analyzed their clinical data, disease characteristics according to Montreal classification, endoscopic and computed tomography (CT) examinations at initial visit, and 2-year, 5-year, and last follow-ups. We categorized the long-term disease course into four categories: remission, stable, chronic refractory, and chronic relapsing. Significant factors associated with a poorer prognosis were analyzed.Results: The median follow-up period was 107 (range, 61-139) months. Complicated disease behavior increased slightly (20.5% to 26.2%). Chronic refractory (19.6%) and relapsing (16.1%) courses were defined as unfavorable disease course. Two-year disease characteristics were significant factors for unfavorable disease course, and the combination of 2-year perianal disease and 2-year moderate-to-severe CT activity could predict unfavorable disease course with the highest accuracy (0.722, area under the curve 0.768, p