title: Advanced age impacts surgical characteristics and postoperative course in patients with Crohn's disease.
abstract: OBJECTIVE
  Due to a lack of data, the present study was designed to assess the impact of advanced age on surgical characteristics and short-term outcome of patients operated on for symptomatic Crohn's disease.
  
  
  METHODS
  We enrolled 454 consecutive Crohn's disease patients, who underwent intestinal resection at an academic tertiary referral center between 1997 and 2012. Patients were divided into 3 groups according to their age (group I: <30 years, group II: 30-50 years, group III: >50 years) and analyzed retrospectively.
  
  
  RESULTS
  Altogether, 152 (33.5%) patients were included in group I, 234 (51.5%) in group II and 68 (15.0%) in group III. Abscess formation and penetrating disease were significantly more common in younger patients (p = 0.0014 and p = 0.0182). The number of intestinal resections was higher in older patients (p < 0.0001), whereas the laparoscopic approach was more frequently observed in younger adults (p = 0.0006). Group II (n = 58 (24.8%)) and group III (n = 15 (22.1%)) showed significantly more complications compared to group I (n = 20 (13.2%)) (p = 0.0346). Notably, major complications and anastomotic leaks were significantly higher in older patients (p = 0.0004).
  
  
  CONCLUSIONS
  Crohn's disease patients of advanced age show different surgical characteristics compared to younger patients and are at an increased risk of developing postoperative complications.
authors.affiliation: Medical University of Vienna, Department of Surgery, Austria.
authors.forename: Stanislaus
authors.initials: S
authors.lastname: Argeny
authors.affiliation: Medical University of Vienna, Department of Surgery, Austria. Electronic address: anton.stift@meduniwien.ac.at.
authors.forename: Anton
authors.initials: A
authors.lastname: Stift
authors.affiliation: Medical University of Vienna, Center for Medical Statistics, Informatics, and Intelligent Systems, Austria.
authors.forename: Martina
authors.initials: M
authors.lastname: Mittlböck
authors.affiliation: Royal Bournemouth Hospital, United Kingdom.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Lord
authors.affiliation: Medical University of Vienna, Department of Surgery, Austria.
authors.forename: Svenja
authors.initials: S
authors.lastname: Maschke
authors.affiliation: Medical University of Vienna, Department of Surgery, Austria.
authors.forename: Mathias
authors.initials: M
authors.lastname: Schneeweiß
authors.affiliation: Medical University of Vienna, Department of Surgery, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Riss
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Age; Complications; Crohn's disease; Resection; Surgery