Factors that determine risk for surgery in pediatric patients with crohn's disease

Marc E. Schaefer, Jason T. Machan, David Kawatu, Christine R. Langton, James Markowitz, Wallace Crandall, David R. Mack, Jonathan S. Evans, Marian D. Pfefferkorn, Anne M. Griffiths, Anthony R. Otley, Athos Bousvaros, Subra Kugathasan, Joel R. Rosh, David J. Keljo, Ryan S. Carvalho, Gitit Tomer, Petar Mamula, Marsha H. Kay, Benny Kerzner & 5 others Maria Oliva-Hemker, Michael D. Kappelman, Shehzad A. Saeed, Jeffrey S. Hyams, Neal S. LeLeiko

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background & Aims: We examined the incidence of Crohn's disease (CD)-related surgery in a multi-center, inception cohort of pediatric patients with CD. We also examined the effect of starting immunomodulator therapy within 30 days of diagnosis. Methods: Data from 854 children with CD from the Pediatric Inflammatory Bowel Disease Collaborative Research Group who were diagnosed with CD between 2002 and 2008 were analyzed. Results: Overall, 76 (9%) underwent a first CD-related surgery, 57 (7%) underwent a first bowel surgery (bowel resection, ostomy, strictureplasty, or appendectomy), and 19 (2%) underwent a first non-bowel surgery (abscess drainage or fistulotomy). The cumulative risks for bowel surgery, non-bowel surgery, and all CD-related surgeries were 3.4%, 1.4%, and 4.8%, respectively, at 1 year after diagnosis and 13.8%, 4.5%, and 17.7%, respectively, at 5 years after diagnosis. Older age at diagnosis, greater disease severity, and stricturing or penetrating disease increased the risk of bowel surgery. Disease between the transverse colon and rectum decreased the risk. Initiation of immunomodulator therapy within 30 days of diagnosis, sex, race, and family history of inflammatory bowel disease did not influence the risk of bowel surgery. Conclusions: In an analysis of pediatric patients with CD, the 5-year cumulative risk of bowel surgery was lower than that reported in recent studies of adult and pediatric patients but similar to that of a recent retrospective pediatric study. Initiation of immunomodulator therapy at diagnosis did not alter the risk of surgery within 5 years of diagnosis.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
Volume8
Issue number9
DOIs
StatePublished - Sep 2010
Externally publishedYes

Fingerprint

Crohn Disease
Pediatrics
Immunologic Factors
Inflammatory Bowel Diseases
Ostomy
Transverse Colon
Appendectomy
Rectum
Abscess
Drainage
Therapeutics
Retrospective Studies
Incidence

Keywords

  • Abscess Drainage
  • Intestinal Resection
  • Pediatric Crohn's Disease
  • Penetrating
  • Stricture
  • Surgery

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Schaefer, M. E., Machan, J. T., Kawatu, D., Langton, C. R., Markowitz, J., Crandall, W., ... LeLeiko, N. S. (2010). Factors that determine risk for surgery in pediatric patients with crohn's disease. Clinical Gastroenterology and Hepatology, 8(9). https://doi.org/10.1016/j.cgh.2010.05.021

Factors that determine risk for surgery in pediatric patients with crohn's disease. / Schaefer, Marc E.; Machan, Jason T.; Kawatu, David; Langton, Christine R.; Markowitz, James; Crandall, Wallace; Mack, David R.; Evans, Jonathan S.; Pfefferkorn, Marian D.; Griffiths, Anne M.; Otley, Anthony R.; Bousvaros, Athos; Kugathasan, Subra; Rosh, Joel R.; Keljo, David J.; Carvalho, Ryan S.; Tomer, Gitit; Mamula, Petar; Kay, Marsha H.; Kerzner, Benny; Oliva-Hemker, Maria; Kappelman, Michael D.; Saeed, Shehzad A.; Hyams, Jeffrey S.; LeLeiko, Neal S.

In: Clinical Gastroenterology and Hepatology, Vol. 8, No. 9, 09.2010.

Research output: Contribution to journalArticle

Schaefer, ME, Machan, JT, Kawatu, D, Langton, CR, Markowitz, J, Crandall, W, Mack, DR, Evans, JS, Pfefferkorn, MD, Griffiths, AM, Otley, AR, Bousvaros, A, Kugathasan, S, Rosh, JR, Keljo, DJ, Carvalho, RS, Tomer, G, Mamula, P, Kay, MH, Kerzner, B, Oliva-Hemker, M, Kappelman, MD, Saeed, SA, Hyams, JS & LeLeiko, NS 2010, 'Factors that determine risk for surgery in pediatric patients with crohn's disease', Clinical Gastroenterology and Hepatology, vol. 8, no. 9. https://doi.org/10.1016/j.cgh.2010.05.021
Schaefer, Marc E. ; Machan, Jason T. ; Kawatu, David ; Langton, Christine R. ; Markowitz, James ; Crandall, Wallace ; Mack, David R. ; Evans, Jonathan S. ; Pfefferkorn, Marian D. ; Griffiths, Anne M. ; Otley, Anthony R. ; Bousvaros, Athos ; Kugathasan, Subra ; Rosh, Joel R. ; Keljo, David J. ; Carvalho, Ryan S. ; Tomer, Gitit ; Mamula, Petar ; Kay, Marsha H. ; Kerzner, Benny ; Oliva-Hemker, Maria ; Kappelman, Michael D. ; Saeed, Shehzad A. ; Hyams, Jeffrey S. ; LeLeiko, Neal S. / Factors that determine risk for surgery in pediatric patients with crohn's disease. In: Clinical Gastroenterology and Hepatology. 2010 ; Vol. 8, No. 9.
@article{002600e84add4b77bb24a970a8fe1811,
title = "Factors that determine risk for surgery in pediatric patients with crohn's disease",
abstract = "Background & Aims: We examined the incidence of Crohn's disease (CD)-related surgery in a multi-center, inception cohort of pediatric patients with CD. We also examined the effect of starting immunomodulator therapy within 30 days of diagnosis. Methods: Data from 854 children with CD from the Pediatric Inflammatory Bowel Disease Collaborative Research Group who were diagnosed with CD between 2002 and 2008 were analyzed. Results: Overall, 76 (9{\%}) underwent a first CD-related surgery, 57 (7{\%}) underwent a first bowel surgery (bowel resection, ostomy, strictureplasty, or appendectomy), and 19 (2{\%}) underwent a first non-bowel surgery (abscess drainage or fistulotomy). The cumulative risks for bowel surgery, non-bowel surgery, and all CD-related surgeries were 3.4{\%}, 1.4{\%}, and 4.8{\%}, respectively, at 1 year after diagnosis and 13.8{\%}, 4.5{\%}, and 17.7{\%}, respectively, at 5 years after diagnosis. Older age at diagnosis, greater disease severity, and stricturing or penetrating disease increased the risk of bowel surgery. Disease between the transverse colon and rectum decreased the risk. Initiation of immunomodulator therapy within 30 days of diagnosis, sex, race, and family history of inflammatory bowel disease did not influence the risk of bowel surgery. Conclusions: In an analysis of pediatric patients with CD, the 5-year cumulative risk of bowel surgery was lower than that reported in recent studies of adult and pediatric patients but similar to that of a recent retrospective pediatric study. Initiation of immunomodulator therapy at diagnosis did not alter the risk of surgery within 5 years of diagnosis.",
keywords = "Abscess Drainage, Intestinal Resection, Pediatric Crohn's Disease, Penetrating, Stricture, Surgery",
author = "Schaefer, {Marc E.} and Machan, {Jason T.} and David Kawatu and Langton, {Christine R.} and James Markowitz and Wallace Crandall and Mack, {David R.} and Evans, {Jonathan S.} and Pfefferkorn, {Marian D.} and Griffiths, {Anne M.} and Otley, {Anthony R.} and Athos Bousvaros and Subra Kugathasan and Rosh, {Joel R.} and Keljo, {David J.} and Carvalho, {Ryan S.} and Gitit Tomer and Petar Mamula and Kay, {Marsha H.} and Benny Kerzner and Maria Oliva-Hemker and Kappelman, {Michael D.} and Saeed, {Shehzad A.} and Hyams, {Jeffrey S.} and LeLeiko, {Neal S.}",
year = "2010",
month = "9",
doi = "10.1016/j.cgh.2010.05.021",
language = "English (US)",
volume = "8",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "9",

}

TY - JOUR

T1 - Factors that determine risk for surgery in pediatric patients with crohn's disease

AU - Schaefer, Marc E.

AU - Machan, Jason T.

AU - Kawatu, David

AU - Langton, Christine R.

AU - Markowitz, James

AU - Crandall, Wallace

AU - Mack, David R.

AU - Evans, Jonathan S.

AU - Pfefferkorn, Marian D.

AU - Griffiths, Anne M.

AU - Otley, Anthony R.

AU - Bousvaros, Athos

AU - Kugathasan, Subra

AU - Rosh, Joel R.

AU - Keljo, David J.

AU - Carvalho, Ryan S.

AU - Tomer, Gitit

AU - Mamula, Petar

AU - Kay, Marsha H.

AU - Kerzner, Benny

AU - Oliva-Hemker, Maria

AU - Kappelman, Michael D.

AU - Saeed, Shehzad A.

AU - Hyams, Jeffrey S.

AU - LeLeiko, Neal S.

PY - 2010/9

Y1 - 2010/9

N2 - Background & Aims: We examined the incidence of Crohn's disease (CD)-related surgery in a multi-center, inception cohort of pediatric patients with CD. We also examined the effect of starting immunomodulator therapy within 30 days of diagnosis. Methods: Data from 854 children with CD from the Pediatric Inflammatory Bowel Disease Collaborative Research Group who were diagnosed with CD between 2002 and 2008 were analyzed. Results: Overall, 76 (9%) underwent a first CD-related surgery, 57 (7%) underwent a first bowel surgery (bowel resection, ostomy, strictureplasty, or appendectomy), and 19 (2%) underwent a first non-bowel surgery (abscess drainage or fistulotomy). The cumulative risks for bowel surgery, non-bowel surgery, and all CD-related surgeries were 3.4%, 1.4%, and 4.8%, respectively, at 1 year after diagnosis and 13.8%, 4.5%, and 17.7%, respectively, at 5 years after diagnosis. Older age at diagnosis, greater disease severity, and stricturing or penetrating disease increased the risk of bowel surgery. Disease between the transverse colon and rectum decreased the risk. Initiation of immunomodulator therapy within 30 days of diagnosis, sex, race, and family history of inflammatory bowel disease did not influence the risk of bowel surgery. Conclusions: In an analysis of pediatric patients with CD, the 5-year cumulative risk of bowel surgery was lower than that reported in recent studies of adult and pediatric patients but similar to that of a recent retrospective pediatric study. Initiation of immunomodulator therapy at diagnosis did not alter the risk of surgery within 5 years of diagnosis.

AB - Background & Aims: We examined the incidence of Crohn's disease (CD)-related surgery in a multi-center, inception cohort of pediatric patients with CD. We also examined the effect of starting immunomodulator therapy within 30 days of diagnosis. Methods: Data from 854 children with CD from the Pediatric Inflammatory Bowel Disease Collaborative Research Group who were diagnosed with CD between 2002 and 2008 were analyzed. Results: Overall, 76 (9%) underwent a first CD-related surgery, 57 (7%) underwent a first bowel surgery (bowel resection, ostomy, strictureplasty, or appendectomy), and 19 (2%) underwent a first non-bowel surgery (abscess drainage or fistulotomy). The cumulative risks for bowel surgery, non-bowel surgery, and all CD-related surgeries were 3.4%, 1.4%, and 4.8%, respectively, at 1 year after diagnosis and 13.8%, 4.5%, and 17.7%, respectively, at 5 years after diagnosis. Older age at diagnosis, greater disease severity, and stricturing or penetrating disease increased the risk of bowel surgery. Disease between the transverse colon and rectum decreased the risk. Initiation of immunomodulator therapy within 30 days of diagnosis, sex, race, and family history of inflammatory bowel disease did not influence the risk of bowel surgery. Conclusions: In an analysis of pediatric patients with CD, the 5-year cumulative risk of bowel surgery was lower than that reported in recent studies of adult and pediatric patients but similar to that of a recent retrospective pediatric study. Initiation of immunomodulator therapy at diagnosis did not alter the risk of surgery within 5 years of diagnosis.

KW - Abscess Drainage

KW - Intestinal Resection

KW - Pediatric Crohn's Disease

KW - Penetrating

KW - Stricture

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=77956171908&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956171908&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2010.05.021

DO - 10.1016/j.cgh.2010.05.021

M3 - Article

VL - 8

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 9

ER -