title: Long-term prognosis of the jejunal involvement of Crohn's disease.
abstract: OBJECTIVE
  We investigated the prognosis of Crohn's disease (CD) in Korean patients with jejunal involvement.
  
  
  BACKGROUND
  Although jejunal involvement is considered a poor prognostic factor of CD in whites, it has never been validated in Asian populations.
  
  
  METHODS
  We retrospectively reviewed the medical records of 1403 Korean CD patients (median age at diagnosis, 23 years; male patients, 72.3%; median follow-up duration, 65 mo). Probabilities of medication use, surgery, and hospitalization were analyzed by a Cox proportional hazards model and a Poisson regression model.
  
  
  RESULTS
  Jejunal involvement was observed in 198 of 1403 (14.1%) patients at diagnosis. There were more ileal location (28.3% vs. 20.6%, P<0.001) and stricturing behavior (16.7% vs. 9.4%, P=0.001) in the jejunal group than in the non-jejunal group. In univariate analyses, the cumulative probabilities of treatment with corticosteroids (P=0.014) and thiopurines (P=0.008), the first major surgery (P=0.021), and the first hospitalization (P=0.015) were significantly higher in the jejunal than in the non-jejunal group. In multivariate analyses, jejunal involvement was independently associated with the more common use of corticosteroids [hazard ratio, 1.24; 95% confidence interval (CI), 1.02-1.50] and thiopurines (hazard ratio, 1.26; 95% CI, 1.06-1.49), higher incidence rates of strictureplasties [relative risk (RR), 2.52; 95% CI, 1.60-3.96] and hospitalizations (RR, 1.29; 95% CI, 1.14-1.47), and longer hospitalization duration (RR, 1.30; 95% CI, 1.25-1.34).
  
  
  CONCLUSIONS
  Korean CD patients are more likely to have jejunal involvement than western patients. Jejunal involvement is one of the poor prognostic factors in Korean CD patients, as it is in westerners.
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Park
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Park
authors.forename: Sang Hyoung
authors.initials: SH
authors.lastname: Park
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.forename: Kee Wook
authors.initials: KW
authors.lastname: Jung
authors.forename: Kyung Jo
authors.initials: KJ
authors.lastname: Kim
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Chang Sik
authors.initials: CS
authors.lastname: Yu
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003251:Constriction, Pathologic / Q000150:complications; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007583:Jejunum / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult