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移动监测系统可检测新诊断克罗恩病患者的疾病活动模式,并显示其与临床结局的关联。

Mobile monitoring system detects the disease activity pattern and shows the association with clinical outcomes in patients with newly diagnosed Crohn's disease.

作者信息

Lee Yoo Jin, Kwak Sang Gyu, Kim Eun Soo, Kim Sung Kook, Lee Hyun Seok, Chung Yun Jin, Jang Byung Ik, Kim Kyeong Ok, Kim Jeongseok, Jo Hyeong Ho, Kim Eun Young

机构信息

Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.

Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu, South Korea.

出版信息

Sci Rep. 2024 Apr 24;14(1):9405. doi: 10.1038/s41598-024-59914-7.

Abstract

We aimed to determine whether Crohn's disease (CD) activity patterns assessed via a web-based symptom diary can help predict clinical outcomes in patients with newly diagnosed CD. Patients diagnosed with CD within the preceding 3 months were prospectively enrolled at four tertiary centers. All patients recorded their symptoms on a website using a smartphone at least once a week. The index outcomes were disease-related admission and surgery during follow-up. The disease activity from enrollment to outcome or last follow-up was reviewed for pattern analysis. Cox regression analysis was used to identify the predictors of disease outcomes. A total of 102 patients were enrolled. During a median follow-up period of 42 months, 25 (24.5%) and 6 (5.9%) patients required admission and surgery, respectively. Poor activity pattern was an independent predictor of disease-related hospitalization (adjusted hazard ratio [aHR], 3.96; 95% confidence interval [CI] 1.5-10.45; p = 0.005). A poor activity pattern (aHR, 19.48; 95% CI 1.86-203.95; p = 0.013) and female sex (aHR, 11.28; 95% CI 1.49-85.01; p = 0.018) were found to be independent predictors of bowel resection. CD disease activity patterns monitored through the mobile monitoring system may help predict clinical outcomes, such as disease-related hospitalization and surgery, in patients with newly diagnosed CD.

摘要

我们旨在确定通过基于网络的症状日记评估的克罗恩病(CD)活动模式是否有助于预测新诊断的CD患者的临床结局。在过去3个月内被诊断为CD的患者在四个三级中心进行前瞻性入组。所有患者每周至少使用智能手机在网站上记录一次症状。指标结局为随访期间与疾病相关的入院和手术情况。回顾从入组到结局或最后一次随访的疾病活动情况以进行模式分析。采用Cox回归分析确定疾病结局的预测因素。共入组102例患者。在中位随访期42个月期间,分别有25例(24.5%)和6例(5.9%)患者需要入院和手术。不良活动模式是与疾病相关住院的独立预测因素(调整后风险比[aHR],3.96;95%置信区间[CI] 1.5 - 10.45;p = 0.005)。发现不良活动模式(aHR,19.48;95% CI 1.86 - 203.95;p = 0.013)和女性(aHR,11.28;95% CI 1.49 - 85.01;p = 0.018)是肠切除的独立预测因素。通过移动监测系统监测的CD疾病活动模式可能有助于预测新诊断CD患者的临床结局,如与疾病相关的住院和手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4a/11043071/1acf9992766c/41598_2024_59914_Fig1_HTML.jpg

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