title: Risk factors regarding the need for a second operation in patients with Crohn's disease.
abstract: OBJECTIVE
  The majority of Crohn's disease patients undergo surgery. However, the factors that predict post-operative recurrence remain controversial. The aim of the present study was to shed light on the potential predictors of such recurrence.
  
  
  METHODS
  86 patients who underwent operative procedures for Crohn's disease were retrospectively studied. Recurrence was defined as the need for a second operation. Life table and multivariate analysis were performed to find the predictors of recurrence.
  
  
  RESULTS
  In 26/86 (30%) of the patients, post-operative recurrence was diagnosed within a mean of 42 months of the follow-up. Logistic regression analysis revealed that smoking (OR 3.69, 95% CI 2.06-11.52) and perforating disease (OR 4.09, 95% CI 1.31-12.65) were associated with a risk of recurrence. However, survival analysis showed that only perforating disease was associated with an early post-operative recurrence (log-rank test, p < 0.001). Neither resected surgical specimen characteristics, nor the duration and the location of the disease were found to predict the need for a second operation.
  
  
  CONCLUSIONS
  The risk for Crohn's disease patients who undergo surgery is related to the presence of perforating disease and smoking, which predict the need for a second operation. The former is associated with an even earlier recurrence.
authors.affiliation: Department of Gastroenterology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Avidan
authors.forename: E
authors.initials: E
authors.lastname: Sakhnini
authors.forename: A
authors.initials: A
authors.lastname: Lahat
authors.forename: A
authors.initials: A
authors.lastname: Lang
authors.forename: M
authors.initials: M
authors.lastname: Koler
authors.forename: O
authors.initials: O
authors.lastname: Zmora
authors.forename: S
authors.initials: S
authors.lastname: Bar-Meir
authors.forename: Y
authors.initials: Y
authors.lastname: Chowers
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011379:Prognosis; D012008:Recurrence; D012017:Referral and Consultation; D012044:Regression Analysis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects