Socioeconomic deprivation does not influence the severity of Crohn's disease: Results of a prospective multicenter study.
BACKGROUND
Socioeconomic deprivation is associated with poor health. The aims of this study were to evaluate the influence of deprivation in the characteristics and comparisons of deprived and nondeprived Crohn's disease (CD) patients.


METHODS
CD patients were prospectively recruited from September 2006 to June 2007 in 6 hospitals in the Paris area. To assess the level of deprivation we used the EPICES score (Evaluation of Precarity and Inequalities in Health Examination Centers; http://www.cetaf.asso.fr), a validated individual index of deprivation developed in France, a score >30 defining deprivation. We defined CD as severe when at least 1 of the conventionally predefined criteria of clinical severity was present.


RESULTS
In all, 207 patients (128 women and 79 men, mean age 40 years) were included and had a median score of deprivation of 20.7 (0-100). Seventy-three (35%) were deprived. There were no statistical differences between deprived and nondeprived patients for the following parameters: 1) mean age: 39 +/- 14.6 versus 40.6 +/- 13.5, P = 0.4; 2) sex ratio (female/male): 87/47 (65%) versus 41/32 (56%), P = 0.2; 3) duration of disease (years) 9 +/- 8.8 versus 8.5 +/- 7.2, P = 0.7; 4) delay from onset of symptoms to diagnosis >1 year: 22/115 (19%) versus 13/63 (21%), P = 0.8; and 5) severity of disease 71% versus 70% (P = 0.9). Nondeprived patients had a lower rate of hospitalization (40 versus 56%, P = 0,04) and a higher rate of surgery (44 versus 22%, P = 0,004); the rate of surgery was only identified by logistic regression.


CONCLUSIONS
In this study deprivation does not seem to influence the severity of CD. This can be explained by easy access to healthcare in France.
Nahon
Stéphane
S
Hôpital de Montfermeil, France. snahon@ch-montfermeil.fr
Lahmek
Pierre
P
Macaigne
Gilles
G
Faurel
Jean-Pierre
JP
Sass
Catherine
C
Howaizi
Mehran
M
Fleury
Antoine
A
Baju
A
A
Locher
Christophe
C
Barjonet
Georges
G
Saillant
GillesGatineau
G
Moulin
Jean-Jacques
JJ
Poupardin
Cécile
C
D000328:Adult; D003424:Crohn Disease / Q000191:economics* / Q000453:epidemiology* / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010297:Paris / Q000453:epidemiology; D011446:Prospective Studies; D012720:Severity of Illness Index; D012923:Social Class; D011795:Surveys and Questionnaires