P255 Association of penetrating disease and hypoalbuminemia with Crohn's disease anastomotic recurrence in the biological era: results of a long-term experience from a tertiary IBD center Article Swipe
Stefano Cardelli
,
D Gerti
,
Giacomo Calini
,
Arnaldo Amato
,
L Sissa
,
Lorenzo Serafini
,
Fernando Rizzello
,
Paolo Gionchetti
,
Gilberto Poggioli
,
Matteo Rottoli
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/ecco-jcc/jjad212.0385
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/ecco-jcc/jjad212.0385
Background Crohn's disease (CD) anastomotic recurrence remains a clinical challenge with significant consequences. Its relationship with perioperative factors is controversial. This study investigates factors associated with surgical and endoscopic recurrence in a large historical cohort during the biological era. Methods Retrospective series of consecutive patients who underwent primary ileocecal resection for CD and the subsequent follow-up at our institute between 2004 and 2021. Follow-up or surgery for recurrence carried out in other centres were exclusion criteria. Primary outcome: identifying the variables associated with the surgical recurrence defined the need for surgery for the recurrence of disease at the site of the previous anastomosis. Secondary outcome: identifying the variables associated with the endoscopic recurrence, according to Rutgeert's score. Univariate comparisons and multivariable Cox regression survival analyses were performed accordingly. Results Out of 417 patients followed in our centre with a median follow-up time of 85 months (IQR 47-114), 170 presented with an endoscopic recurrence after a median time of 46 months (IQR 13-79). Surgical recurrence was observed in 65 patients at a median time of 85 months (IQR 47-114). The five-year surgical and endoscopic recurrence-free survival rates were 92.7% and 68%, respectively, while the 10-year surgical and endoscopic recurrence-free survival rates were 78% and 47%, respectively (Figure 1). At the multivariate Cox regression, the risk of endoscopic recurrence was significantly associated with male gender (HR 1.47, 95%CI 1.03–2.09, p=0.03) and current smoking (HR 1.47,95%CI 1.03–2.09, p=0.03). Penetrating disease behavior was significantly associated with a lower risk of both endoscopic (HR 0.71, 95%CI 0.5–0.99, p=0.04) and surgical recurrence (HR 0.44, 95%CI 0.25–0.8, p=0.007), as well as the albumin levels at the time of primary surgery (HR for endoscopic recurrence: 0.7, 95%CI 0.52 –0.92, p=0.01; HR for surgical recurrence 0.6, 95%CI 0.36–0.96, p=0.03) (Table 1). Conclusion The role of penetrating disease as a risk factor for recurrence should be reassessed in the biological era. Hypoalbuminemia could represent a useful indicator in the stratification of patients at high risk of recurrence.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ecco-jcc/jjad212.0385
- https://academic.oup.com/ecco-jcc/article-pdf/18/Supplement_1/i609/56347319/jjad212.0385.pdf
- OA Status
- bronze
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4391163758
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Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4391163758Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/ecco-jcc/jjad212.0385Digital Object Identifier
- Title
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P255 Association of penetrating disease and hypoalbuminemia with Crohn's disease anastomotic recurrence in the biological era: results of a long-term experience from a tertiary IBD centerWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
-
2024-01-01Full publication date if available
- Authors
-
Stefano Cardelli, D Gerti, Giacomo Calini, Arnaldo Amato, L Sissa, Lorenzo Serafini, Fernando Rizzello, Paolo Gionchetti, Gilberto Poggioli, Matteo RottoliList of authors in order
- Landing page
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https://doi.org/10.1093/ecco-jcc/jjad212.0385Publisher landing page
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https://academic.oup.com/ecco-jcc/article-pdf/18/Supplement_1/i609/56347319/jjad212.0385.pdfDirect link to full text PDF
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YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/ecco-jcc/article-pdf/18/Supplement_1/i609/56347319/jjad212.0385.pdfDirect OA link when available
- Concepts
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Medicine, Perioperative, Anastomosis, Surgery, Retrospective cohort study, Crohn's disease, Proportional hazards model, Hypoalbuminemia, Univariate analysis, Disease, Cohort, Internal medicine, Multivariate analysisTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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