부산대학교 도서관

Background. Predicting severe Crohn's disease (SCD) can assist in planning risk reduction therapy for SCD, thereby improving disease outcomes. Objective. To determine the prevalence and predictors of SCD in a sample of South African (SA) patients. Methods. This was a retrospective chart review of patients with Crohn's disease (CD) attending the gastroenterology unit at a tertiary hospital in Durban, SA. Demographic and clinical variables at diagnosis of CD were collected and analysed for statistical associations with SCD (defined as the presence of [greater than or equal to]1 of the following over the course of CD: complex perianal disease, colonic resection, [greater than or equal to]2 small-bowel resections, a single small-bowel resection >50cm, or construction of a definitive stoma). The prognostic utility of statistically significant variables was investigated by establishing their sensitivity, specificity and predictive values for SCD. Results. The study sample consisted of 93 patients. The rate of SCD was 64.5%, with 63.3% of patients developing SCD within 1 year of CD diagnosis. Ileocolonic location (p=0.046) and penetrating disease at initial diagnosis of CD (p=0.021) were statistically associated with SCD. The sensitivity, specificity, positive predictive value and negative predictive value of ileocolonic location for SCD were 72.7%, 47.4%, 66.7% and 54.6%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of penetrating disease for SCD were 85.7%, 41.7%, 30.0% and 91.0%, respectively. Conclusion. Most patients with CD developed SCD within 1 year of their CD diagnosis. CD with a penetrating phenotype at diagnosis is a good predictor for the development of SCD and should be further investigate. S Afr Med J 2024;114(4):e1667. https://doi.org/10.7196/SAMJ.2024.v114i4.1667
Crohn's disease (CD) is a subtype of inflammatory bowel disease, involving inflammation of the gastrointestinal tract. CD results from an interaction between genetic and environmental factors. It tends to affect [...]