title: Clinical features and predictors of clinical outcomes in Korean patients with Crohn's disease: a Korean association for the study of intestinal diseases multicenter study.
abstract: OBJECTIVE
  Although differences in genetic susceptibility and the clinical features of Crohn's disease (CD) have been reported between Asian and Caucasian patients, the disease course and predictors of CD in Asians remains poorly defined. The study therefore aimed to investigate factors predictive of the clinical outcomes of patients with CD in a Korean population.
  
  
  METHODS
  This retrospective multicenter cohort study included 728 Korean CD patients from 13 university hospitals. The first CD-related surgery or need for immunosuppressive or biological agents were regarded as the clinical outcomes of interest.
  
  
  RESULTS
  A total of 126 (17.3%) CD patients underwent CD-related surgery, while 473 (65.0%) and 196 (26.9%) were prescribed thiopurine drugs and infliximab, respectively. Multivariate Cox regression analysis identified current (hazard ratio [HR] = 1.86; P = 0.018) and former smoking habits (HR = 1.78; P = 0.049), stricturing (HR = 2.24; P < 0.001), and penetrating disease behavior at diagnosis (HR = 3.07; P < 0.001) as independent predictors associated with the first CD-related surgery. With respect to immunosuppressive and biological agents, younger age (< 40 years) (HR = 2.17; P < 0.001 and HR = 2.10; P = 0.006, respectively), ileal involvement (HR = 1.36; P = 0.035 and HR = 2.17; P = 0.006, respectively), and perianal disease (HR = 1.42; P = 0.001 and HR = 1.38; P = 0.038, respectively) at diagnosis were significant predictors for the need of these medications.
  
  
  CONCLUSIONS
  In Korean patients with CD, stricturing, penetrating disease behavior, and smoking habits at the time of diagnosis are independent predictors for CD-related surgery. It was also identified that younger age (< 40 years), ileal involvement, and perianal disease at diagnosis are predictive of a need for immunosuppressive or biological agents.
authors: Department of Internal Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
authors: Chang Mo
authors: CM
authors: Moon
authors: Dong Il
authors: DI
authors: Park
authors: Eun Ran
authors: ER
authors: Kim
authors: Young-Ho
authors: YH
authors: Kim
authors: Chang Kyun
authors: CK
authors: Lee
authors: Suck-Ho
authors: SH
authors: Lee
authors: Jae Hak
authors: JH
authors: Kim
authors: Kyu-Chan
authors: KC
authors: Huh
authors: Sung-Ae
authors: SA
authors: Jung
authors: Soon Man
authors: SM
authors: Yoon
authors: Hyun Joo
authors: HJ
authors: Song
authors: Hyun Joo
authors: HJ
authors: Jang
authors: You Sun
authors: YS
authors: Kim
authors: Kang-Moon
authors: KM
authors: Lee
authors: Jeong Eun
authors: JE
authors: Shin
mesh_terms: D000328:Adult; D001004:Anus Diseases; D044466:Asian People; D015331:Cohort Studies; D003424:Crohn Disease / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D005544:Forecasting; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D015337:Multicenter Studies as Topic; D012044:Regression Analysis; D012189:Retrospective Studies; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: Crohn's disease; biological agent; immunosuppressant; predictor; surgery