title: Risk factors for surgery and postoperative recurrence: analysis of a south China cohort with Crohn's disease.
abstract: OBJECTIVE
  To investigate the risk factors for primary surgery and postoperative recurrence in a cohort of Chinese Crohn's disease (CD) patients.
  
  
  METHODS
  Medical notes of consecutive diagnosed patients from 2003 until 2010 were reviewed. Fifty-seven postoperative patients--finished regular follow-up--were recruited for postoperative recurrence analysis.
  
  
  RESULTS
  One hundred eleven of 323 (34.4%) patients of this cohort underwent primary surgery. The cumulative frequency of resection was 16.6%, 35.4%, 53%, and 94.5% for 1, 5, 10, and 30 years, respectively, after onset of disease. Male (OR: 1.994; 95% CI: 1.291-3.078, p = 0.002), stricture (OR: 4.832; 95% CI: 3.064-7.621, p = 0.000), or penetrating (OR: 4.923; 95% CI: 3.060-7.919, p = 0.000) were associated with an increased risk for primary surgery, while early use of immunomodulators was (OR: 0.438; 95% CI: 0.218-0.880, p = 0.020) associated with a decreased risk. Fifty-seven (21.1%) patients were diagnosed as postoperative clinical recurrence and the cumulative recurrence rates were 6.1%, 17.1%, and 36.8% for 1, 2, and 3 years, respectively. Perianal disease was associated with an increased risk for clinical recurrence (OR: 5.606; 95% CI: 1.59-19.766, p = 0.007).
  
  
  CONCLUSIONS
  The operation frequency is high in CD. Male, penetrating, and stricture diseases are associated with an increased risk for primary surgery while early use of immunomodulators is associated with a decreased risk. The postoperative recurrence rate is also high. Patients with perianal disease are at higher risk for clinical recurrence.
authors: Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan Er Road, Guangzhou, PR China.
authors: Xiang
authors: X
authors: Gao
authors: Rong-Ping
authors: RP
authors: Yang
authors: Min-Hu
authors: MH
authors: Chen
authors: Ying-Lian
authors: YL
authors: Xiao
authors: Yao
authors: Y
authors: He
authors: Bai-Li
authors: BL
authors: Chen
authors: Pin-Jin
authors: PJ
authors: Hu
mesh_terms: D000328:Adult; D017668:Age of Onset; D001004:Anus Diseases / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003424:Crohn Disease / Q000453:epidemiology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D007416:Intestinal Perforation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D011182:Postoperative Care / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors