Disease history in 382 Italian patients with Crohn's disease.
OBJECTIVE
This large-scale study was aimed at evaluating the long-term history of Crohn's disease in a cohort of consecutive patients referred to the Careggi Hospital in Florence from January 1973 to June 1996.


METHODS
A total of 382 patients (187 females, 195 males; mean age of 47 years) were included in our study. The median follow-up was more than 11 years and only 46 patients (12%) had a follow-up of less than 1 year. The main endpoints evaluated in these patients included mortality for any cause, disease-specific mortality, recurrences, and need for surgery. Furthermore, in a subgroup of 130 patients observed during the last 6 months of our study, a more detailed assessment of the disease was carried out in which the distribution of inflammatory, fibrostenosing and fistulizing forms was determined.


RESULTS
Our results showed that the disease-specific mortality rate was extremely low (around 3% at 10 years and 5% at 20 years), but the rate of recurrence was approximately 50% at 3 years and more than 60% at 6 years. Surgery was needed in more than 50% of the patients over the 10 years following diagnosis, and the risk of a second operation was of a further 30% within 4 years of the first operation.


CONCLUSIONS
These epidemiological data emerging from our study are interesting since a large patient population was evaluated and the duration of the follow-up is extremely long.
Vannozzi
G
G
Department of Gastroenterology, Careggi Hospital, Florence, Italy.
Fontana
R
R
Milla
M
M
Bonanomi
A G
AG
Trallori
G
G
Gabbrielli
M
M
Pacini
F
F
Leandro
G
G
Morettini
A
A
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D015331:Cohort Studies; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate