Published online Jul 6, 2020. doi: 10.12998/wjcc.v8.i13.2769
Peer-review started: March 3, 2020
First decision: April 25, 2020
Revised: May 26, 2020
Accepted: June 13, 2020
Article in press: June 13, 2020
Published online: July 6, 2020
Patients affected by Crohn's disease (CD) are more likely to develop gastrointestinal stenosis and often undergo surgery during the duration of disease.
To identify the risk factors for gastrointestinal stenosis in hospitalized CD patients in China.
The clinical data of CD patients hospitalized at the Seventh Medical Center, Chinese People's Liberation Army General Hospital from January 2010 to December 2018 were included. Patients with gastrointestinal stenosis were compared to those without gastrointestinal stenosis for clinical variables. The risk factors for gastrointestinal stenosis were identified using univariate and multivariable logistic regression analyses. The treatments for patients with gastrointestinal stenosis were analyzed, and the characteristics of different treatment methods were discussed.
The incidence of gastrointestinal stenosis was 59.02% in the 122 hospitalized CD patients. Age of onset of more than 40 years (odds ratio [OR] = 3.072, 95% confidence interval [CI]: 1.298-7.272, P = 0.009) and duration of disease of more than 5 years (OR = 2.101, 95%CI: 1.002-4.406, P = 0.048) were associated with the occurrence of gastrointestinal stenosis. Fifteen (20.83%) patients did not undergo surgery and received internal medicine and nutrition treatment. Surgical treatments were performed in 72.22% (52) of cases. The rate of postoperative complications was 15.38% (8 cases), and during a median follow-up period of 46 mo, 11.54% (6 cases) underwent reoperation. A total of 29.17% (21 cases) were treated with endoscopic therapy, and during a median follow-up period of 32 mo, 76.19% (16 cases) had no surgical event, 23.81% (5 cases) failed to avoid surgical treatments, and no serious postoperative complications occurred after endoscopic therapy.
Age of onset of more than 40 years and duration of disease of more than 5 years may be strongly correlated with a higher risk of gastrointestinal stenosis in hospitalized CD patients. Endoscopic therapy for gastrointestinal stenosis is relatively safe and effective, and may help to prevent or delay surgery.
Core tip: We retrospectively analyzed the clinical information of 122 cases of hospitalized patients with Crohn's disease. Demographics, disease activity, classification, treatment, and complications were compared between patients with and without gastrointestinal stenosis. It was found that age of onset of more than 40 years and duration of disease of more than 5 years were correlated with the occurrence of gastrointestinal stenosis. Endoscopic therapy has gradually become one of the main methods for the treatment of Crohn's disease-related gastrointestinal stenosis due to its safe and effective characteristics.