title: Predictive factors for an uncomplicated long-term course of Crohn's disease: a retrospective analysis.
abstract: BACKGROUND
  Predictive factors for a mild course of Crohn's disease (CD) may have therapeutic consequences, but as yet have not been identified.
  
  
  OBJECTIVE
  To identify baseline factors that predict mild CD and design a predictive scoring system.
  
  
  METHODS
  A retrospective, multicenter study of newly diagnosed CD patients allocated to mild CD (no therapy, mesalazine only, or mesalazine with a single initial short course of low-dose prednisone) or moderate CD (all other patients including resected patients).
  
  
  RESULTS
  162 patients (median follow-up 43 months) were analyzed: 47 mild CD and 115 moderate CD. For mild CD versus moderate CD, mean age at first diagnosis was higher (41.1 versus 33.9 years, p=0.02), mean C-reactive protein (CRP) concentration was lower (1.6 versus 3.6 mg/L, p<0.01), and perianal lesions were less frequent (0% versus 10.4%, p=0.02). The combined incidence of complications (stenosis, any type of fistula, extraintestinal complications or fever) was 21.3% in mild CD versus 35.7% in moderate CD (p=0.07). A scoring system based on age, CRP, endoscopic severity (adapted Rutgeert's score), perianal lesions and combined incidence of complications was developed which can predict a mild prognosis at the initial diagnosis, giving patients the chance of simplified therapy and accelerated step-up in the event of treatment failure.
  
  
  CONCLUSIONS
  Approximately a third of CD patients experience a mild disease course and require only basic therapy. A possible scoring system to predict mild CD which may avoid overtreatment and unnecessary risks for the patient and costs is suggested.
authors.affiliation: Evangelisches Krankenhaus Kalk, Innere Medizin, Köln, Germany. kruis@evkk.de
authors.forename: W
authors.initials: W
authors.lastname: Kruis
authors.forename: A
authors.initials: A
authors.lastname: Katalinic
authors.forename: T
authors.initials: T
authors.lastname: Klugmann
authors.forename: G-R
authors.initials: GR
authors.lastname: Franke
authors.forename: J
authors.initials: J
authors.lastname: Weismüller
authors.forename: L
authors.initials: L
authors.lastname: Leifeld
authors.forename: S
authors.initials: S
authors.lastname: Ceplis-Kastner
authors.forename: B
authors.initials: B
authors.lastname: Reimers
authors.forename: B
authors.initials: B
authors.lastname: Bokemeyer
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine; D011241:Prednisone