Publication

Risk Factors for the Development of Fistulae and Stenoses in Crohn Disease Patients in the Swiss Inflammatory Bowel Disease Cohort

Journal Paper/Review - Feb 25, 2017

Units
PubMed
Doi

Citation
Zeitz J, Rogler G, Fried M, Sulz M, Vavricka S, Scharl S, Misselwitz B, Frei P, Biedermann L, Labenz C, Fournier N, Scharl M. Risk Factors for the Development of Fistulae and Stenoses in Crohn Disease Patients in the Swiss Inflammatory Bowel Disease Cohort. Inflamm Intest Dis 2017; 1:172-181.
Type
Journal Paper/Review (English)
Journal
Inflamm Intest Dis 2017; 1
Publication Date
Feb 25, 2017
Issn Electronic
2296-9365
Pages
172-181
Brief description/objective

Background
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.

Summary
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).

Key Messages
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.