Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Inflamm Bowel Dis. 2022 Jun 2;28(Suppl 2):S35-S41. doi: 10.1093/ibd/izab295.
There is lack of real-world data for disease behavior and surgery of Crohn's disease (CD) from large-scale Chinese cohorts.
Hospitalized patients diagnosed with CD in our center were consecutively included from January 2000 to December 2018. Disease behavior progression was defined as the initial classification of B1 to the progression of B2 or B3. Clinical characteristics including demographics, disease classification and activity, medical therapy, development of cancers, and death were collected.
Overall, 504 patients were included. Two hundred thirty-one (45.8%) patients were initially classified as B1; 30 (13.0%), 71 (30.7%), and 95 (41.1%) of them had disease progression at the 1-year follow-up, 5-year follow-up, and overall, respectively. Patients without location transition before behavior transition were less likely to experience behavior progression. However, patients without previous exposure to a corticosteroid, immunomodulator, or biological agent had a greater chance of experiencing behavior progression. When the long-term prognosis was evaluated, 211 (41.9%) patients underwent at least 1 CD-related surgery; 108 (21.4%) and 120 (23.8%) of these patients underwent surgery before and after their diagnosis, respectively. An initial classification as B1, no behavior transition, no surgery prior to diagnosis, and previous corticosteroid exposure during follow-up were associated with a lower risk of undergoing surgery.
This study depicts the clinical features and factors associated with behavior progression and surgery among hospitalized CD patients in a Chinese center. Behavior progression is associated with a higher probability of CD-related surgery, and strengthened therapies are necessary for them in the early phase.
缺乏来自大规模中国队列的克罗恩病（CD）疾病行为和手术的真实世界数据。
本中心 2000 年 1 月至 2018 年 12 月连续纳入经住院诊断为 CD 的患者。疾病行为进展定义为初始分类为 B1 进展为 B2 或 B3。收集了包括人口统计学、疾病分类和活动、药物治疗、癌症发生和死亡等临床特征。
共纳入 504 例患者。231 例（45.8%）患者最初被分类为 B1；其中 30、71 和 95 例患者在 1 年、5 年和总体随访时分别发生疾病进展。在行为转变前无部位转移的患者不太可能出现行为进展。然而，没有皮质类固醇、免疫调节剂或生物制剂既往暴露史的患者更有可能出现行为进展。在评估长期预后时，211 例（41.9%）患者至少接受过 1 次 CD 相关手术；其中 108 例（21.4%）和 120 例（23.8%）患者分别在诊断前和诊断后接受了手术。初始分类为 B1、无行为转变、诊断前无手术以及随访期间皮质类固醇暴露与手术风险降低相关。
本研究描述了中国中心住院 CD 患者的行为进展和手术相关的临床特征和相关因素。行为进展与 CD 相关手术的可能性增加相关，需要在早期对其进行强化治疗。
