Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn’s Disease

Yoshifumi Watanabe, Norikatsu Miyoshi, Shiki Fujino, Hidekazu Takahashi, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori, Tsunekazu Mizushima

研究成果: ジャーナルへの寄稿記事

抄録

Background: Intestinal failure is the most critical complication of Crohn’s disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications. Aims: The purpose of this study was to investigate the incidence and risk factors for intestinal failure in Crohn’s disease. Methods: We performed a retrospective analysis of Crohn’s disease patients (162 cases) at Osaka University Hospital between January 2000 and December 2017. Kaplan–Meier analysis was used to investigate the cumulative incidence of intestinal failure. To identify the risk factors of intestinal failure, patient characteristics were analyzed by multivariate analysis, including disease classification, surgical history, medical treatment other than surgery, and cumulative inflammation was calculated using the average C-reactive protein value and disease duration. Results: The cumulative incidence of intestinal failure 5, 10, and 15 years after Crohn’s disease diagnosis was 2.6%, 3.4%, and 8.6%, respectively. Multivariate analysis identified the following as independent risk factors for intestinal failure in Crohn’s disease: residual small intestinal length < 200 cm (odds ratio 7.51, 95% confidence interval 2.14–29.96), non-use of anti-tumor necrosis factor-alpha therapy (3.34, 1.22–10.74), and cumulative inflammation (1.01, 1.001–1.038). We created a new predictive nomogram consisting of these risk factors. Conclusions: Intestinal failure occasionally occurred during long-term treatment of Crohn’s disease. Cumulative inflammation for the first time, in addition to short residual small intestinal length and non-use of anti-tumor necrosis factor-alpha therapy, was shown to be potential risk factors for intestinal failure in Crohn’s disease.

元の言語英語
ページ(範囲)2280-2285
ページ数6
ジャーナルDigestive Diseases and Sciences
64
発行部数8
DOI
出版物ステータス出版済み - 8 15 2019

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Crohn Disease
Inflammation
Incidence
Multivariate Analysis
Tumor Necrosis Factor-alpha
Home Parenteral Nutrition
Nomograms
Therapeutics
C-Reactive Protein
History
Odds Ratio
Quality of Life
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

これを引用

Watanabe, Y., Miyoshi, N., Fujino, S., Takahashi, H., Haraguchi, N., Hata, T., ... Mizushima, T. (2019). Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn’s Disease. Digestive Diseases and Sciences, 64(8), 2280-2285. https://doi.org/10.1007/s10620-019-05553-2

Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn’s Disease. / Watanabe, Yoshifumi; Miyoshi, Norikatsu; Fujino, Shiki; Takahashi, Hidekazu; Haraguchi, Naotsugu; Hata, Taishi; Matsuda, Chu; Yamamoto, Hirofumi; Doki, Yuichiro; Mori, Masaki; Mizushima, Tsunekazu.

:: Digestive Diseases and Sciences, 巻 64, 番号 8, 15.08.2019, p. 2280-2285.

研究成果: ジャーナルへの寄稿記事

Watanabe, Y, Miyoshi, N, Fujino, S, Takahashi, H, Haraguchi, N, Hata, T, Matsuda, C, Yamamoto, H, Doki, Y, Mori, M & Mizushima, T 2019, 'Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn’s Disease', Digestive Diseases and Sciences, 巻. 64, 番号 8, pp. 2280-2285. https://doi.org/10.1007/s10620-019-05553-2
Watanabe, Yoshifumi ; Miyoshi, Norikatsu ; Fujino, Shiki ; Takahashi, Hidekazu ; Haraguchi, Naotsugu ; Hata, Taishi ; Matsuda, Chu ; Yamamoto, Hirofumi ; Doki, Yuichiro ; Mori, Masaki ; Mizushima, Tsunekazu. / Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn’s Disease. :: Digestive Diseases and Sciences. 2019 ; 巻 64, 番号 8. pp. 2280-2285.
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abstract = "Background: Intestinal failure is the most critical complication of Crohn’s disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications. Aims: The purpose of this study was to investigate the incidence and risk factors for intestinal failure in Crohn’s disease. Methods: We performed a retrospective analysis of Crohn’s disease patients (162 cases) at Osaka University Hospital between January 2000 and December 2017. Kaplan–Meier analysis was used to investigate the cumulative incidence of intestinal failure. To identify the risk factors of intestinal failure, patient characteristics were analyzed by multivariate analysis, including disease classification, surgical history, medical treatment other than surgery, and cumulative inflammation was calculated using the average C-reactive protein value and disease duration. Results: The cumulative incidence of intestinal failure 5, 10, and 15 years after Crohn’s disease diagnosis was 2.6{\%}, 3.4{\%}, and 8.6{\%}, respectively. Multivariate analysis identified the following as independent risk factors for intestinal failure in Crohn’s disease: residual small intestinal length < 200 cm (odds ratio 7.51, 95{\%} confidence interval 2.14–29.96), non-use of anti-tumor necrosis factor-alpha therapy (3.34, 1.22–10.74), and cumulative inflammation (1.01, 1.001–1.038). We created a new predictive nomogram consisting of these risk factors. Conclusions: Intestinal failure occasionally occurred during long-term treatment of Crohn’s disease. Cumulative inflammation for the first time, in addition to short residual small intestinal length and non-use of anti-tumor necrosis factor-alpha therapy, was shown to be potential risk factors for intestinal failure in Crohn’s disease.",
author = "Yoshifumi Watanabe and Norikatsu Miyoshi and Shiki Fujino and Hidekazu Takahashi and Naotsugu Haraguchi and Taishi Hata and Chu Matsuda and Hirofumi Yamamoto and Yuichiro Doki and Masaki Mori and Tsunekazu Mizushima",
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AU - Watanabe, Yoshifumi

AU - Miyoshi, Norikatsu

AU - Fujino, Shiki

AU - Takahashi, Hidekazu

AU - Haraguchi, Naotsugu

AU - Hata, Taishi

AU - Matsuda, Chu

AU - Yamamoto, Hirofumi

AU - Doki, Yuichiro

AU - Mori, Masaki

AU - Mizushima, Tsunekazu

PY - 2019/8/15

Y1 - 2019/8/15

N2 - Background: Intestinal failure is the most critical complication of Crohn’s disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications. Aims: The purpose of this study was to investigate the incidence and risk factors for intestinal failure in Crohn’s disease. Methods: We performed a retrospective analysis of Crohn’s disease patients (162 cases) at Osaka University Hospital between January 2000 and December 2017. Kaplan–Meier analysis was used to investigate the cumulative incidence of intestinal failure. To identify the risk factors of intestinal failure, patient characteristics were analyzed by multivariate analysis, including disease classification, surgical history, medical treatment other than surgery, and cumulative inflammation was calculated using the average C-reactive protein value and disease duration. Results: The cumulative incidence of intestinal failure 5, 10, and 15 years after Crohn’s disease diagnosis was 2.6%, 3.4%, and 8.6%, respectively. Multivariate analysis identified the following as independent risk factors for intestinal failure in Crohn’s disease: residual small intestinal length < 200 cm (odds ratio 7.51, 95% confidence interval 2.14–29.96), non-use of anti-tumor necrosis factor-alpha therapy (3.34, 1.22–10.74), and cumulative inflammation (1.01, 1.001–1.038). We created a new predictive nomogram consisting of these risk factors. Conclusions: Intestinal failure occasionally occurred during long-term treatment of Crohn’s disease. Cumulative inflammation for the first time, in addition to short residual small intestinal length and non-use of anti-tumor necrosis factor-alpha therapy, was shown to be potential risk factors for intestinal failure in Crohn’s disease.

AB - Background: Intestinal failure is the most critical complication of Crohn’s disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications. Aims: The purpose of this study was to investigate the incidence and risk factors for intestinal failure in Crohn’s disease. Methods: We performed a retrospective analysis of Crohn’s disease patients (162 cases) at Osaka University Hospital between January 2000 and December 2017. Kaplan–Meier analysis was used to investigate the cumulative incidence of intestinal failure. To identify the risk factors of intestinal failure, patient characteristics were analyzed by multivariate analysis, including disease classification, surgical history, medical treatment other than surgery, and cumulative inflammation was calculated using the average C-reactive protein value and disease duration. Results: The cumulative incidence of intestinal failure 5, 10, and 15 years after Crohn’s disease diagnosis was 2.6%, 3.4%, and 8.6%, respectively. Multivariate analysis identified the following as independent risk factors for intestinal failure in Crohn’s disease: residual small intestinal length < 200 cm (odds ratio 7.51, 95% confidence interval 2.14–29.96), non-use of anti-tumor necrosis factor-alpha therapy (3.34, 1.22–10.74), and cumulative inflammation (1.01, 1.001–1.038). We created a new predictive nomogram consisting of these risk factors. Conclusions: Intestinal failure occasionally occurred during long-term treatment of Crohn’s disease. Cumulative inflammation for the first time, in addition to short residual small intestinal length and non-use of anti-tumor necrosis factor-alpha therapy, was shown to be potential risk factors for intestinal failure in Crohn’s disease.

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