Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2020; 8(13): 2769-2777
Published online Jul 6, 2020. doi: 10.12998/wjcc.v8.i13.2769
Correlation between age of onset and gastrointestinal stenosis in hospitalized patients with Crohn's disease
Shan-Bing Yang, Shu-Wen Du, Ji-Heng Wang
Shan-Bing Yang, Shu-Wen Du, Ji-Heng Wang, Department of Gastroenterology, the Seventh Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100700, China
Author contributions: Yang SB and Du SW contributed equally to this paper.
Supported by Capital Health Development Research Fund, No. 2018-1-5091; National Key R and D Program of China, No. 2017YFC0112304.
Institutional review board statement: The study was reviewed and approved for publication by our Institutional Reviewer.
Informed consent statement: Due to the nature of the retrospective study, informed consent from all study participants was waived.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at E-mail: lileiyouan@ccmu.edu.cn.
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: Ji-Heng Wang, PhD, Chief Doctor, the Seventh Medical Center, Chinese People’s Liberation Army General Hospital, No.5, Nanmengcang Hutong, Beijing 100700, China. lileiyouan@ccmu.edu.cn
Received: March 3, 2020
Peer-review started: March 3, 2020
First decision: April 25, 2020
Revised: May 26, 2020
Accepted: June 13, 2020
Article in press: June 13, 2020
Published online: July 6, 2020
Processing time: 125 Days and 16.8 Hours
ARTICLE HIGHLIGHTS
Research background

With the development of society, the incidence and prevalence of Crohn's disease (CD) are increasing. CD-related gastrointestinal stenosis is one of the most common serious complications, leading to surgery, loss of labor, increased medical costs, and reduced quality of life. At present, there is a lack of clinical data on CD-related gastrointestinal stenosis in China.

Research motivation

The identification of the factors related to CD-related gastrointestinal stenosis and the analysis of its treatment methods are conducive to improving clinicians' understanding of this disease and reducing or delaying the occurrence of gastrointestinal stenosis.

Research objectives

The primary aim of this study was to investigate the related factors and treatments for CD-related gastrointestinal stenosis.

Research methods

The clinical data of CD patients hospitalized at our medical center from January 2010 to December 2018 were included, and patients with gastrointestinal stenosis were compared to a control group (non-gastrointestinal stenosis) for clinical variables. The risk factors for gastrointestinal stenosis were identified using univariate and multivariable logistic regression analyses. The treatments for patients with gastrointestinal stenosis were analyzed, and the characteristics of different treatment methods were discussed.

Research results

The incidence of gastrointestinal stenosis was 59.02% in the 122 hospitalized CD patients. Age of onset of more than 40 years (odds ratio = 3.072, 95%CI: 1.298-7.272, P = 0.009) and duration of disease of more than 5 years (odds ratio = 2.101, 95%CI: 1.002-4.406, P = 0.048) were associated with the occurrence of gastrointestinal stenosis. Fifteen (20.83%) patients did not undergo surgery and received internal medicine and nutrition treatment. Surgical treatments were performed in 72.22% (52 cases). The rate of postoperative complications was 15.38% (8 cases), and during a median follow-up of 46 mo, 11.54% (6 cases) underwent surgery again. A total of 29.17% (21 cases) were treated with endoscopic therapy, and during a median follow-up of 32 mo, 76.19% (16 cases) had no surgical event, 23.81% (5 cases) failed to avoid surgical treatments, and no serious postoperative complications occurred after endoscopic therapy.

Research conclusions

In this study, we found for the first time that age of onset of more than 40 years may be a risk factor for CD-related gastrointestinal stenosis, and the correlation between duration of disease of more than 5 years and CD-related gastrointestinal stenosis was also found, but no significant correlation between fistula and gastrointestinal stenosis was found. Endoscopic therapy for gastrointestinal stenosis is relatively safe and effective, and may help to prevent or delay surgery. All these are beneficial to reduce the incidence of gastrointestinal stenosis and improve its therapeutic effect in the future clinical practice.

Research perspectives

Considering the limitations in the selection of participants in this study, further studies are warranted to define the profile of predictors of CD-related gastrointestinal stenosis.