title: Risk factors for short bowel syndrome in patients with Crohn's disease.
abstract: OBJECTIVE
  Patients with Crohn's disease (CD) often need home parenteral nutrition for short bowel syndrome (SBS), as a result of frequent surgery and extended bowel resections. We conducted this study to evaluate the influence of the patient's condition on the occurrence of SBS in CD.
  
  
  METHODS
  The subjects of this study were 721 patients, who underwent bowel resections for CD at Hyogo College of Medicine between September 1974 and September 2010. The collective total of bowel resection operations was 1286. The possible risk factors for SBS were analyzed by univariate and multivariate logistic regression analyses to determine their predictive significance.
  
  
  RESULTS
  SBS was diagnosed in 24 patients. A stepwise logistic regression model revealed that penetrating type (odds ratio 14.9, p = 0.02), remaining small intestine <200 cm (odds ratio 141.4, p < 0.01), ostomy creation (odds ratio 7.5, p = 0.03), and post-total colectomy (odds ratio 17.6, p < 0.01) were independent risk factors for SBS.
  
  
  CONCLUSIONS
  These results indicate that the length of remaining small bowel is closely related to SBS in patients who have undergone surgery for CD. At least 200 cm of small bowel should be preserved to prevent SBS when total colectomy and ostomy creation are performed for CD.
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. motoi.uchino@nifty.ne.jp
authors.forename: Motoi
authors.initials: M
authors.lastname: Uchino
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeuchi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Bando
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takesue
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015984:Causality; D002648:Child; D003082:Colectomy; D015897:Comorbidity; D003424:Crohn Disease / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007421:Intestine, Small / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010030:Ostomy / Q000706:statistics & numerical data; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000453:epidemiology*; D055815:Young Adult