Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2020; 26(5): 524-534
Published online Feb 7, 2020. doi: 10.3748/wjg.v26.i5.524
Development of a prognostic model for one-year surgery risk in Crohn’s disease patients: A retrospective study
Jia-Yin Yao, Yi Jiang, Jia Ke, Yi Lu, Jun Hu, Min Zhi
Jia-Yin Yao, Yi Jiang, Min Zhi, Department of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510655, Guangdong Province, China
Jia Ke, Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510655, Guangdong Province, China
Yi Lu, Department of Anesthesiology, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou 510130, Guangdong Province, China
Jun Hu, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510655, Guangdong Province, China
Author contributions: All authors have made a significant contribution to this research article; Yao JY contributed to study concept and design, data analysis, and manuscript drafting; Jiang Y contributed to data acquisition and analysis; Hu J contributed to study concept and design; Ke J contributed to critical revision of the manuscript; Zhi M contributed to final approval of the version to be submitted; all authors approved the final manuscript as well as the authorship list.
Supported by the National Natural Science Foundation of China, No. 81900490, No. 81670477, and No. 81600419.
Institutional review board statement: This study was approved by the Ethics Committee of Sun Yat-Sen University (2019ZSLYEC-058) and was permitted by the Chinese Clinical Trial Registry (ChiCTR1900025751).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Min Zhi, MD, PhD, Doctor, Professor, Department of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-Sen University, No. 26, Yuancun Second Road, Guangzhou 510655, Guangdong Province, China. doctorzhimin@163.com
Received: November 19, 2019
Peer-review started: November 19, 2019
First decision: December 12, 2019
Revised: January 6, 2020
Accepted: January 15, 2020
Article in press: January 15, 2020
Published online: February 7, 2020
Processing time: 79 Days and 22.3 Hours
ARTICLE HIGHLIGHTS
Research background

Patients with progressive Crohn’s disease (CD) should be given accelerated therapy.

Research motivation

Predicting CD-related early surgery risk is challenging and important in treatment strategy monitoring.

Research objectives

This study aimed to establish a model to predict CD-related early surgery.

Research methods

This was a retrospective study collecting data from CD patients from January 1, 2012 to December 31, 2016. A prognostic model was established and further validated. A nomogram was developed to facilitate clinical practice.

Research results

A total of 1002 eligible patients were enrolled, and 24.25% received intestinal surgery within 1 year after diagnosis. Disease behavior, smoking, body mass index and C-reactive protein level at diagnosis, previous perianal or intestinal surgery, maximum bowel wall thickness, use of biologics, and exclusive enteral nutrition were identified as independent significant factors associated with early intestinal surgery.

Research conclusions

This prognostic model can effectively predict CD-related early surgery, serving as the basis for tailored therapy.

Research perspectives

Future studies with a broader population base and more associated factors including endoscopy estimation and genetic markers are needed to perfect this model.