Zeitz Jonas, Fournier Nicolas, Labenz Christian, Biedermann Luc, Frei Pascal, Misselwitz Benjamin, Scharl Sylvie, Vavricka Stephan R, Sulz Michael C, Fried Michael, Rogler Gerhard, Scharl Michael
Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Institute of Social and Preventive Medicine, Université de Lausanne, Lausanne, Switzerland.
Inflamm Intest Dis. 2017 Apr;1(4):172-181. doi: 10.1159/000458144. Epub 2017 Feb 25.
Fistulae and stenoses represent frequent and severe complications in patients with Crohn disease (CD). Our study aimed to identify risk factors for fistula and stenosis formation in CD patients.
We retrieved data of 1,600 CD patients from the nationwide Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS). The risk for fistulae and stenoses in relation to gender, age at diagnosis, smoking status at diagnosis, and ileal involvement at diagnosis were analyzed. In the multivariate analysis, female gender showed a lower risk for developing perianal and any fistula (risk ratio [RR] 0.721, 95% confidence interval [CI] 0.582-0.893, = 0.003 and RR 0.717, 95% CI 0.580-0.888, = 0.002, respectively), and older age at diagnosis showed a lower risk for developing perianal fistula (RR 0.661, 95% CI 0.439-0.995, = 0.047). Furthermore, ileal involvement was associated with a lower risk for perianal fistula (RR 0.713, 95% CI 0.561-0.906, = 0.006), a lower risk for any fistula (RR 0.709, 95% CI 0.558-0.901, = 0.005), and a higher risk for stenosis (RR 2.170, 95% CI 1.728-2.725, < 0.001).
In the nationwide SIBDCS, younger age at diagnosis and male gender were risk factors for developing perianal and nonperianal fistulae. Additionally, ileal involvement was revealed to be a potent risk factor (RR 2.170) for developing a stenosis.
瘘管和狭窄是克罗恩病（CD）患者常见且严重的并发症。我们的研究旨在确定CD患者发生瘘管和狭窄的风险因素。
我们从全国性的瑞士炎症性肠病队列研究（SIBDCS）中检索了1600例CD患者的数据。分析了与性别、诊断时年龄、诊断时吸烟状况以及诊断时回肠受累情况相关的发生瘘管和狭窄的风险。在多变量分析中，女性发生肛周瘘管和任何瘘管的风险较低（风险比[RR]分别为0.721，95%置信区间[CI]为0.582 - 0.893，P = 0.003；RR为0.717，95% CI为0.580 - 0.888，P = 0.002），诊断时年龄较大发生肛周瘘管的风险较低（RR为0.661，95% CI为0.439 - 0.995，P = 0.047）。此外，回肠受累与肛周瘘管风险较低（RR为0.713，95% CI为0.561 - 0.906，P = 0.006）、任何瘘管风险较低（RR为0.709，95% CI为0.558 - 0.901，P = 0.005）以及狭窄风险较高（RR为2.170，95% CI为1.728 - 2.725，P < 0.001）相关。
在全国性的SIBDCS中，诊断时年龄较小和男性是发生肛周和非肛周瘘管的风险因素。此外，回肠受累被发现是发生狭窄的一个重要风险因素（RR为2.170）。
