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炎症性肠病的生物治疗、手术和住院率:成人和儿科患者的拉丁美洲观察性比较研究。

Biological therapy, surgery, and hospitalization rates for inflammatory bowel disease: An observational Latin American comparative study between adults and pediatric patients.

机构信息

Health Sciences Postgraduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.

Health Sciences Postgraduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.

出版信息

Gastroenterol Hepatol. 2024 Oct;47(8):813-820. doi: 10.1016/j.gastrohep.2023.10.006. Epub 2023 Oct 26.

Abstract

OBJECTIVE

Compare the proportions of use of biological therapy, surgeries, and hospitalizations between adults and pediatric inflammatory bowel disease (IBD)-Crohn's disease (CD) and ulcerative colitis (UC)-patients.

PATIENTS AND METHODS

Observational, retrospective, and multicenter study. Data were collected from all consecutive IBD patients seen as outpatients or admitted to hospital, during 2015-2021, in two IBD tertiary centers in a South Brazilian capital. Patients with unclassified colitis diagnosis were excluded from this study. Patients were classified as having CD or UC and sub-categorized as adult or pediatric according to age. Data were analyzed using frequency, proportion, Fisher's exact test, and Chi-square test.

RESULTS

A total of 829 patients were included: 509 with CD (378 adults/131 pediatric) and 320 with UC (225/95). Among patients with CD, no differences were observed for proportions of use of biological therapy (80.2% in pediatric vs. 73.3% in adults; P=0.129), surgery (46.6% vs. 50.8%; P=0.419), or hospitalization (64.9% vs. 56.9%; P=0.122). In UC, significant differences were observed for biological therapy (40.0% vs. 28.0%; P=0.048) and hospitalization (47.4% vs. 24.0%; P<0.001). No significant difference was observed in surgery rates (17.9% vs. 12.4%; P=0.219).

CONCLUSIONS

Biological therapy and incidence of hospitalization were greater among pediatric patients with UC, compared with adults; no difference was observed in the need for abdominal surgery. In CD, no significant difference was observed in the three main outcomes between the age groups.

摘要

目的

比较成人和儿童炎症性肠病(IBD)-克罗恩病(CD)和溃疡性结肠炎(UC)患者之间生物治疗、手术和住院治疗的使用比例。

患者和方法

这是一项观察性、回顾性和多中心研究。2015 年至 2021 年期间,在巴西南部首府的两个 IBD 三级中心,连续收集所有作为门诊或住院患者就诊的 IBD 患者的数据。本研究排除了未明确诊断为结肠炎的患者。根据年龄,患者分为 CD 或 UC,并进一步分为成人或儿童。使用频率、比例、Fisher 确切检验和卡方检验对数据进行分析。

结果

共纳入 829 例患者:509 例 CD(378 例成人/131 例儿童)和 320 例 UC(225 例/95 例)。在 CD 患者中,生物治疗(儿科 80.2% vs. 成人 73.3%;P=0.129)、手术(46.6% vs. 50.8%;P=0.419)或住院治疗(64.9% vs. 56.9%;P=0.122)的使用比例无差异。在 UC 中,生物治疗(40.0% vs. 28.0%;P=0.048)和住院治疗(47.4% vs. 24.0%;P<0.001)的差异有统计学意义。手术率(17.9% vs. 12.4%;P=0.219)无显著差异。

结论

与成人相比,患有 UC 的儿科患者需要更多的生物治疗和住院治疗;两组在腹部手术需求方面无差异。在 CD 中,两组在这三个主要结局方面无显著差异。

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