Phenotype at diagnosis predicts recurrence rates in Crohn's disease.

F. Wolters, M.G.V. Russel, J. Sijbrandij, T. Ambergen, S. Odes, L. Riis, E. Langholz, P. Politi, A. Qasim, I. Koutroubakis, E. Tsianos, S. Vermeire, J. Freitas, G. van Zeijl, O. Hoie, T. Bernklev, M. Beltrami, D. Rodriguez, R.W. Stockbrugger, B. Moum

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AB - BACKGROUND: In Crohn's disease (CD), studies associating phenotype at diagnosis and subsequent disease activity are important for patient counselling and health care planning. AIMS: To calculate disease recurrence rates and to correlate these with phenotypic traits at diagnosis. METHODS: A prospectively assembled uniformly diagnosed European population-based inception cohort of CD patients was classified according to the Vienna Classification for disease phenotype at diagnosis. Surgical and non-surgical recurrence rates throughout a ten-year follow-up period were calculated. Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease. RESULTS: A total of 358 were classified for phenotype at diagnosis of whom 262 (73.2%) had a first recurrence and 113 patients (31.6%) a first surgical recurrence during the first 10 years after diagnosis. Patients with upper gastrointestinal disease at diagnosis had excess risk of recurrences (Hazard Ratio (HR): 1.54, 95% Confidence Interval (CI): 1.13 - 2.10) whereas age >/=40 years at diagnosis was protective (HR: 0.82, 95% CI: 0.70 - 0.97). Colonic disease was a protective characteristic for resective surgery (HR: 0.38, 95% CI: 0.21 - 0.69). More frequent resective surgical recurrences were reported from Copenhagen (HR: 3.23, 95% CI: 1.32 - 7.89). CONCLUSIONS: A mild course of disease in terms of disease recurrence was observed in this European cohort. Phenotype at diagnosis had predictive value for disease recurrence with upper gastro-intestinal disease being the most important positive predictor. A phenotypic North- South gradient in CD may be present illustrated by higher surgery risks in some of the Northern-European centres
Original languageEnglish
Pages (from-to)1124-1130
Issue number8
Publication statusPublished - 1 Jan 2006

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Wolters, F., Russel, M. G. V., Sijbrandij, J., Ambergen, T., Odes, S., Riis, L., Langholz, E., Politi, P., Qasim, A., Koutroubakis, I., Tsianos, E., Vermeire, S., Freitas, J., van Zeijl, G., Hoie, O., Bernklev, T., Beltrami, M., Rodriguez, D., Stockbrugger, R. W., & Moum, B. (2006). Phenotype at diagnosis predicts recurrence rates in Crohn's disease. Gut, 55(8), 1124-1130.