Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis
Background: No previous studies have examined predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) with consideration of changes in pouchitis subtypes during follow-up. This study evaluated the independent predictive factors for chronic pouch...
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| Veröffentlicht in: | Digestion 2013-01, Vol.88 (2), p.101-109 |
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| creator | Okita, Yoshiki Araki, Toshimitsu Tanaka, Koji Hashimoto, Kiyoshi Kondo, Satoru Kawamura, Mikio Koike, Yuki Otake, Kohei Fujikawa, Hiroyuki Inoue, Mikihiro Ohi, Masaki Inoue, Yasuhiro Uchida, Keiichi Mohri, Yasuhiko Kusunoki, Masato |
| description | Background: No previous studies have examined predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) with consideration of changes in pouchitis subtypes during follow-up. This study evaluated the independent predictive factors for chronic pouchitis. Methods: A total of 244 consecutive patients who underwent IPAA were enrolled. We assessed the possible associations between pouchitis and clinical factors using Cox proportional hazard regression. Results: 231 patients met the inclusion criteria. 66 (28.5%) patients developed pouchitis. In 9 of 44 (20.4%) patients, antibiotic-responsive pouchitis at the first episode changed into chronic pouchitis after the occurrence of a subsequent episode. The median duration from occurrence of antibiotic-responsive pouchitis to alteration into chronic pouchitis was 502 (range 147-1,697) days. Overall pouchitis was finally classified into 35 acute pouchitis and 31 chronic pouchitis cases. Multivariate analysis revealed that a ≥7.5-g cumulative steroid dose before colectomy and a ≥500-mg monthly steroid dose just before colectomy were significant predictive factors for chronic pouchitis (p = 0.0001 and 0.0095, respectively). Conclusion: Patients with UC and a higher cumulative steroid dose before colectomy or higher monthly steroid dose just before colectomy may have a predictive factor for developing chronic pouchitis. |
| doi_str_mv | 10.1159/000353151 |
| format | Article |
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This study evaluated the independent predictive factors for chronic pouchitis. Methods: A total of 244 consecutive patients who underwent IPAA were enrolled. We assessed the possible associations between pouchitis and clinical factors using Cox proportional hazard regression. Results: 231 patients met the inclusion criteria. 66 (28.5%) patients developed pouchitis. In 9 of 44 (20.4%) patients, antibiotic-responsive pouchitis at the first episode changed into chronic pouchitis after the occurrence of a subsequent episode. The median duration from occurrence of antibiotic-responsive pouchitis to alteration into chronic pouchitis was 502 (range 147-1,697) days. Overall pouchitis was finally classified into 35 acute pouchitis and 31 chronic pouchitis cases. Multivariate analysis revealed that a ≥7.5-g cumulative steroid dose before colectomy and a ≥500-mg monthly steroid dose just before colectomy were significant predictive factors for chronic pouchitis (p = 0.0001 and 0.0095, respectively). Conclusion: Patients with UC and a higher cumulative steroid dose before colectomy or higher monthly steroid dose just before colectomy may have a predictive factor for developing chronic pouchitis.</description><identifier>ISSN: 0012-2823</identifier><identifier>EISSN: 1421-9867</identifier><identifier>DOI: 10.1159/000353151</identifier><identifier>PMID: 23949485</identifier><identifier>CODEN: DIGEBW</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adolescent ; Adult ; Aged ; Child ; Chronic Disease ; Colitis, Ulcerative - surgery ; Colonic Pouches - adverse effects ; Female ; Humans ; Incidence ; Japan - epidemiology ; Male ; Middle Aged ; Original Paper ; Pouchitis - epidemiology ; Pouchitis - etiology ; Retrospective Studies ; Young Adult</subject><ispartof>Digestion, 2013-01, Vol.88 (2), p.101-109</ispartof><rights>2013 S. Karger AG, Basel</rights><rights>Copyright © 2013 S. Karger AG, Basel.</rights><rights>Copyright (c) 2013 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-b515fc238662aed097f902ebf4ac7b8269f3c661e1319eae72e154655f86b9523</citedby><cites>FETCH-LOGICAL-c400t-b515fc238662aed097f902ebf4ac7b8269f3c661e1319eae72e154655f86b9523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,2422,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23949485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okita, Yoshiki</creatorcontrib><creatorcontrib>Araki, Toshimitsu</creatorcontrib><creatorcontrib>Tanaka, Koji</creatorcontrib><creatorcontrib>Hashimoto, Kiyoshi</creatorcontrib><creatorcontrib>Kondo, Satoru</creatorcontrib><creatorcontrib>Kawamura, Mikio</creatorcontrib><creatorcontrib>Koike, Yuki</creatorcontrib><creatorcontrib>Otake, Kohei</creatorcontrib><creatorcontrib>Fujikawa, Hiroyuki</creatorcontrib><creatorcontrib>Inoue, Mikihiro</creatorcontrib><creatorcontrib>Ohi, Masaki</creatorcontrib><creatorcontrib>Inoue, Yasuhiro</creatorcontrib><creatorcontrib>Uchida, Keiichi</creatorcontrib><creatorcontrib>Mohri, Yasuhiko</creatorcontrib><creatorcontrib>Kusunoki, Masato</creatorcontrib><title>Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis</title><title>Digestion</title><addtitle>Digestion</addtitle><description>Background: No previous studies have examined predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) with consideration of changes in pouchitis subtypes during follow-up. This study evaluated the independent predictive factors for chronic pouchitis. Methods: A total of 244 consecutive patients who underwent IPAA were enrolled. We assessed the possible associations between pouchitis and clinical factors using Cox proportional hazard regression. Results: 231 patients met the inclusion criteria. 66 (28.5%) patients developed pouchitis. In 9 of 44 (20.4%) patients, antibiotic-responsive pouchitis at the first episode changed into chronic pouchitis after the occurrence of a subsequent episode. The median duration from occurrence of antibiotic-responsive pouchitis to alteration into chronic pouchitis was 502 (range 147-1,697) days. Overall pouchitis was finally classified into 35 acute pouchitis and 31 chronic pouchitis cases. Multivariate analysis revealed that a ≥7.5-g cumulative steroid dose before colectomy and a ≥500-mg monthly steroid dose just before colectomy were significant predictive factors for chronic pouchitis (p = 0.0001 and 0.0095, respectively). Conclusion: Patients with UC and a higher cumulative steroid dose before colectomy or higher monthly steroid dose just before colectomy may have a predictive factor for developing chronic pouchitis.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Child</subject><subject>Chronic Disease</subject><subject>Colitis, Ulcerative - surgery</subject><subject>Colonic Pouches - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Pouchitis - epidemiology</subject><subject>Pouchitis - etiology</subject><subject>Retrospective Studies</subject><subject>Young Adult</subject><issn>0012-2823</issn><issn>1421-9867</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpd0c9L5DAUB_AgLjq6e_AuEvCih2pefrU5yuy6CoIe9FzSzItW22ZMWsH_fjM74xwkkF983heSR8gRsAsAZS4ZY0IJULBDZiA5FKbS5S6ZMQa84BUX--QgpdfV0UixR_a5MNLISs3I8iHionVj-4H02roxxER9iPQ3fmAXlj0OIw2ezl9iGFpHH8LkXtqxTdT6ESO97dB269viasjbPKUx9CFl0g70qXMY7f_0eehWhT_JD2-7hL826yF5uv7zOL8p7u7_3s6v7gonGRuLRoHyjotKa25xwUzpDePYeGld2VRcGy-c1oAgwKDFkiMoqZXylW6M4uKQnK1zlzG8T5jGum-Tw66zA4Yp1SCFLPOoRKan3-hrmGJ-TVYKuATNWZXV-Vq5GFKK6OtlbHsbP2tg9aoN9bYN2Z5sEqemx8VWfv17Bsdr8GbjM8Yt2NT_A85bim0</recordid><startdate>20130101</startdate><enddate>20130101</enddate><creator>Okita, Yoshiki</creator><creator>Araki, Toshimitsu</creator><creator>Tanaka, Koji</creator><creator>Hashimoto, Kiyoshi</creator><creator>Kondo, Satoru</creator><creator>Kawamura, Mikio</creator><creator>Koike, Yuki</creator><creator>Otake, Kohei</creator><creator>Fujikawa, Hiroyuki</creator><creator>Inoue, Mikihiro</creator><creator>Ohi, Masaki</creator><creator>Inoue, Yasuhiro</creator><creator>Uchida, Keiichi</creator><creator>Mohri, Yasuhiko</creator><creator>Kusunoki, Masato</creator><general>S. Karger AG</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20130101</creationdate><title>Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis</title><author>Okita, Yoshiki ; Araki, Toshimitsu ; Tanaka, Koji ; Hashimoto, Kiyoshi ; Kondo, Satoru ; Kawamura, Mikio ; Koike, Yuki ; Otake, Kohei ; Fujikawa, Hiroyuki ; Inoue, Mikihiro ; Ohi, Masaki ; Inoue, Yasuhiro ; Uchida, Keiichi ; Mohri, Yasuhiko ; Kusunoki, Masato</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-b515fc238662aed097f902ebf4ac7b8269f3c661e1319eae72e154655f86b9523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Child</topic><topic>Chronic Disease</topic><topic>Colitis, Ulcerative - surgery</topic><topic>Colonic Pouches - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Pouchitis - epidemiology</topic><topic>Pouchitis - etiology</topic><topic>Retrospective Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okita, Yoshiki</creatorcontrib><creatorcontrib>Araki, Toshimitsu</creatorcontrib><creatorcontrib>Tanaka, Koji</creatorcontrib><creatorcontrib>Hashimoto, Kiyoshi</creatorcontrib><creatorcontrib>Kondo, Satoru</creatorcontrib><creatorcontrib>Kawamura, Mikio</creatorcontrib><creatorcontrib>Koike, Yuki</creatorcontrib><creatorcontrib>Otake, Kohei</creatorcontrib><creatorcontrib>Fujikawa, Hiroyuki</creatorcontrib><creatorcontrib>Inoue, Mikihiro</creatorcontrib><creatorcontrib>Ohi, Masaki</creatorcontrib><creatorcontrib>Inoue, Yasuhiro</creatorcontrib><creatorcontrib>Uchida, Keiichi</creatorcontrib><creatorcontrib>Mohri, Yasuhiko</creatorcontrib><creatorcontrib>Kusunoki, Masato</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Digestion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okita, Yoshiki</au><au>Araki, Toshimitsu</au><au>Tanaka, Koji</au><au>Hashimoto, Kiyoshi</au><au>Kondo, Satoru</au><au>Kawamura, Mikio</au><au>Koike, Yuki</au><au>Otake, Kohei</au><au>Fujikawa, Hiroyuki</au><au>Inoue, Mikihiro</au><au>Ohi, Masaki</au><au>Inoue, Yasuhiro</au><au>Uchida, Keiichi</au><au>Mohri, Yasuhiko</au><au>Kusunoki, Masato</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis</atitle><jtitle>Digestion</jtitle><addtitle>Digestion</addtitle><date>2013-01-01</date><risdate>2013</risdate><volume>88</volume><issue>2</issue><spage>101</spage><epage>109</epage><pages>101-109</pages><issn>0012-2823</issn><eissn>1421-9867</eissn><coden>DIGEBW</coden><abstract>Background: No previous studies have examined predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) with consideration of changes in pouchitis subtypes during follow-up. This study evaluated the independent predictive factors for chronic pouchitis. Methods: A total of 244 consecutive patients who underwent IPAA were enrolled. We assessed the possible associations between pouchitis and clinical factors using Cox proportional hazard regression. Results: 231 patients met the inclusion criteria. 66 (28.5%) patients developed pouchitis. In 9 of 44 (20.4%) patients, antibiotic-responsive pouchitis at the first episode changed into chronic pouchitis after the occurrence of a subsequent episode. The median duration from occurrence of antibiotic-responsive pouchitis to alteration into chronic pouchitis was 502 (range 147-1,697) days. Overall pouchitis was finally classified into 35 acute pouchitis and 31 chronic pouchitis cases. Multivariate analysis revealed that a ≥7.5-g cumulative steroid dose before colectomy and a ≥500-mg monthly steroid dose just before colectomy were significant predictive factors for chronic pouchitis (p = 0.0001 and 0.0095, respectively). Conclusion: Patients with UC and a higher cumulative steroid dose before colectomy or higher monthly steroid dose just before colectomy may have a predictive factor for developing chronic pouchitis.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>23949485</pmid><doi>10.1159/000353151</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Child Chronic Disease Colitis, Ulcerative - surgery Colonic Pouches - adverse effects Female Humans Incidence Japan - epidemiology Male Middle Aged Original Paper Pouchitis - epidemiology Pouchitis - etiology Retrospective Studies Young Adult |
| title | Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis |
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