Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn’s disease
Background: The aim of our study was to evaluate the frequency and risk factors of clinical postoperative recurrence in Tunisian patients with Crohn’s disease (CD). Methods: Clinical data of 86 patients with CD who underwent ileocolonic resection at University Hospital of Sahloul in Tunisia were ret...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-03-01
|
| Series: | Therapeutic Advances in Gastrointestinal Endoscopy |
| Online Access: | https://doi.org/10.1177/26317745211060689 |
| _version_ | 1798022730184916992 |
|---|---|
| author | Aya Hammami Raida Harbi Nour Elleuch Khaled Ben Meddeb Wafa Ben Ameur Wafa Dahmani Ahlem Braham Salem Ajmi Mehdi Ksiaa Aida Ben Slama Hanen Jaziri Ali Jmaa |
| author_facet | Aya Hammami Raida Harbi Nour Elleuch Khaled Ben Meddeb Wafa Ben Ameur Wafa Dahmani Ahlem Braham Salem Ajmi Mehdi Ksiaa Aida Ben Slama Hanen Jaziri Ali Jmaa |
| author_sort | Aya Hammami |
| collection | DOAJ |
| description | Background: The aim of our study was to evaluate the frequency and risk factors of clinical postoperative recurrence in Tunisian patients with Crohn’s disease (CD). Methods: Clinical data of 86 patients with CD who underwent ileocolonic resection at University Hospital of Sahloul in Tunisia were retrospectively reviewed. Continuous data are expressed as median (interquartile range), and categorical data as frequencies and percentages. Multivariate Cox proportional hazard regression analysis was conducted to identify the risk factors of postoperative clinical recurrence. Results: A total of 86 patients with CD were included in this study. During follow-up, 21 patients (24.4%) had clinical recurrence. The cumulative clinical recurrence rate was 9.3% at 1 year and 20.9% at 5 years. In univariate analysis, predictive factors of postoperative clinical recurrence were active preoperative smoking ( p = 0.008), ileal location of the disease ( p = 0.01), active CD [Crohn’s Disease Activity Index (CDAI) > 150] ( p = 0.04), duration of disease before first surgery <9.5 months ( p = 0.027), and limited resection margins (<2 cm) from macroscopically diseased bowel ( p = 0.005). In multivariate analysis, only smoking ( p = 0.012), duration of disease before first surgery <9.5 months ( p = 0.048), and limited resection margins (<2 cm) from macroscopically diseased bowel ( p = 0.046) were confirmed to be independent factors of clinical relapse. Conclusion: Smoking, duration of disease before first surgery <9.5 months, and limited resection margins (<2 cm) from macroscopically diseased bowel were independent risk factors for clinical recurrence. Based on these factors, patients could be stratified in order to guide postoperative therapeutic options. |
| first_indexed | 2024-04-11T17:34:45Z |
| format | Article |
| id | doaj.art-aa26764b243d4aada2a5d865ee87a314 |
| institution | Directory Open Access Journal |
| issn | 2631-7745 |
| language | English |
| last_indexed | 2024-04-11T17:34:45Z |
| publishDate | 2022-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastrointestinal Endoscopy |
| spelling | doaj.art-aa26764b243d4aada2a5d865ee87a3142022-12-22T04:11:40ZengSAGE PublishingTherapeutic Advances in Gastrointestinal Endoscopy2631-77452022-03-011510.1177/26317745211060689Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn’s diseaseAya HammamiRaida HarbiNour ElleuchKhaled Ben MeddebWafa Ben AmeurWafa DahmaniAhlem BrahamSalem AjmiMehdi KsiaaAida Ben SlamaHanen JaziriAli JmaaBackground: The aim of our study was to evaluate the frequency and risk factors of clinical postoperative recurrence in Tunisian patients with Crohn’s disease (CD). Methods: Clinical data of 86 patients with CD who underwent ileocolonic resection at University Hospital of Sahloul in Tunisia were retrospectively reviewed. Continuous data are expressed as median (interquartile range), and categorical data as frequencies and percentages. Multivariate Cox proportional hazard regression analysis was conducted to identify the risk factors of postoperative clinical recurrence. Results: A total of 86 patients with CD were included in this study. During follow-up, 21 patients (24.4%) had clinical recurrence. The cumulative clinical recurrence rate was 9.3% at 1 year and 20.9% at 5 years. In univariate analysis, predictive factors of postoperative clinical recurrence were active preoperative smoking ( p = 0.008), ileal location of the disease ( p = 0.01), active CD [Crohn’s Disease Activity Index (CDAI) > 150] ( p = 0.04), duration of disease before first surgery <9.5 months ( p = 0.027), and limited resection margins (<2 cm) from macroscopically diseased bowel ( p = 0.005). In multivariate analysis, only smoking ( p = 0.012), duration of disease before first surgery <9.5 months ( p = 0.048), and limited resection margins (<2 cm) from macroscopically diseased bowel ( p = 0.046) were confirmed to be independent factors of clinical relapse. Conclusion: Smoking, duration of disease before first surgery <9.5 months, and limited resection margins (<2 cm) from macroscopically diseased bowel were independent risk factors for clinical recurrence. Based on these factors, patients could be stratified in order to guide postoperative therapeutic options.https://doi.org/10.1177/26317745211060689 |
| spellingShingle | Aya Hammami Raida Harbi Nour Elleuch Khaled Ben Meddeb Wafa Ben Ameur Wafa Dahmani Ahlem Braham Salem Ajmi Mehdi Ksiaa Aida Ben Slama Hanen Jaziri Ali Jmaa Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn’s disease Therapeutic Advances in Gastrointestinal Endoscopy |
| title | Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn’s disease |
| title_full | Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn’s disease |
| title_fullStr | Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn’s disease |
| title_full_unstemmed | Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn’s disease |
| title_short | Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn’s disease |
| title_sort | predictors of postoperative recurrence in a cohort of tunisian patients with crohn s disease |
| url | https://doi.org/10.1177/26317745211060689 |
| work_keys_str_mv | AT ayahammami predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT raidaharbi predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT nourelleuch predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT khaledbenmeddeb predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT wafabenameur predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT wafadahmani predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT ahlembraham predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT salemajmi predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT mehdiksiaa predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT aidabenslama predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT hanenjaziri predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease AT alijmaa predictorsofpostoperativerecurrenceinacohortoftunisianpatientswithcrohnsdisease |