Incidence and clinical impact of perianal disease in patients with ulcerative colitis: A nationwide population‐based study
Background and Aim The risk and clinical impact of perianal disease (PAD) in ulcerative colitis (UC) patients have not been fully evaluated. We investigated the incidence of PAD in UC patients and compared clinical characteristics and outcomes of UC according to the presence of PAD. Methods We perfo...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2019-06, Vol.34 (6), p.1011-1017 |
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| container_title | Journal of gastroenterology and hepatology |
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| creator | Song, Eun Mi Lee, Ho‐Su Kim, Ye‐Jee Oh, Eun Hye Ham, Nam Seok Kim, Jeongseok Hwang, Sung Wook Park, Sang Hyoung Yang, Dong‐Hoon Ye, Byong Duk Byeon, Jeong‐Sik Myung, Seung‐Jae Yang, Suk‐Kyun |
| description | Background and Aim
The risk and clinical impact of perianal disease (PAD) in ulcerative colitis (UC) patients have not been fully evaluated. We investigated the incidence of PAD in UC patients and compared clinical characteristics and outcomes of UC according to the presence of PAD.
Methods
We performed a nationwide population‐based cohort study and a hospital‐based cohort study. Using the 2010–2014 data from the Korean National Health Insurance claims database, we calculated incidence rates and standardized incidence ratios of PAD in UC patients compared with the general population. We evaluated the clinical characteristics and outcomes of UC patients with PAD in both population‐based and hospital‐based cohorts. To reduce clinically meaningful confounding factors, we also conducted matched analyses.
Results
In the population‐based cohort, the incidence rate and standardized incidence ratio of PAD in UC patients were 3.74/1000 person‐years (95% confidence interval, 3.25–4.31) and 2.88 (95% confidence interval, 2.50–3.32), respectively. In the hospital‐based cohort, the cumulative probabilities of PAD at 1, 5, 10, and 20 years after diagnosis were 1.0%, 2.3%, 4.0%, and 6.3%, respectively. In both population‐based and hospital‐based cohorts, UC patients with PAD showed higher proportions of corticosteroid use and extensive colitis at diagnosis. The requirements for anti‐tumor necrosis factor agents and colectomy were significantly higher in UC patients with PAD before and after matched analysis.
Conclusions
The risk of PAD is higher in UC patients than in the general population. UC patients with PAD have distinct clinical features and poor outcomes, as indicated by the greater need for UC‐related medications and colectomy. |
| doi_str_mv | 10.1111/jgh.14555 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2234448147</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2234448147</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3535-57a953c267757805fde2386d1c9251c6ac1f410d95b552d6a21e1d3e1d9eaeac3</originalsourceid><addsrcrecordid>eNp1kM1KxDAURoMoOo4ufAEJuHJRTZrc_riTQWcUwY2uSya51QydtDatw4ALH8Fn9EmMU3XnhXDJx-HA_Qg54uyMhzlfPD2fcQkAW2TEpWQRT2WyTUYs4xDlgud7ZN_7BWNMshR2yZ5gIHMew4i83ThtDTqNVDlDdWWd1aqidtko3dG6pA22VrkQGetReaTW0UZ1Fl3n6cp2z7SvNLYheUWq68p21l_QS-pCUrtVkNOmbvpq8_18_5gHh6G-6836gOyUqvJ4-LPH5PH66mEyi-7upzeTy7tICxAQQapyEDpO0hTSjEFpMBZZYrjOY-A6UZqXkjOTwxwgNomKOXIjwstRodJiTE4Gb9PWLz36rljUfRtu8kUcCyllxmUaqNOB0m3tfYtl0bR2qdp1wVnx3XMRei42PQf2-MfYz5do_sjfYgNwPgArW-H6f1NxO50Nyi_zF4l2</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2234448147</pqid></control><display><type>article</type><title>Incidence and clinical impact of perianal disease in patients with ulcerative colitis: A nationwide population‐based study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Song, Eun Mi ; Lee, Ho‐Su ; Kim, Ye‐Jee ; Oh, Eun Hye ; Ham, Nam Seok ; Kim, Jeongseok ; Hwang, Sung Wook ; Park, Sang Hyoung ; Yang, Dong‐Hoon ; Ye, Byong Duk ; Byeon, Jeong‐Sik ; Myung, Seung‐Jae ; Yang, Suk‐Kyun</creator><creatorcontrib>Song, Eun Mi ; Lee, Ho‐Su ; Kim, Ye‐Jee ; Oh, Eun Hye ; Ham, Nam Seok ; Kim, Jeongseok ; Hwang, Sung Wook ; Park, Sang Hyoung ; Yang, Dong‐Hoon ; Ye, Byong Duk ; Byeon, Jeong‐Sik ; Myung, Seung‐Jae ; Yang, Suk‐Kyun</creatorcontrib><description>Background and Aim
The risk and clinical impact of perianal disease (PAD) in ulcerative colitis (UC) patients have not been fully evaluated. We investigated the incidence of PAD in UC patients and compared clinical characteristics and outcomes of UC according to the presence of PAD.
Methods
We performed a nationwide population‐based cohort study and a hospital‐based cohort study. Using the 2010–2014 data from the Korean National Health Insurance claims database, we calculated incidence rates and standardized incidence ratios of PAD in UC patients compared with the general population. We evaluated the clinical characteristics and outcomes of UC patients with PAD in both population‐based and hospital‐based cohorts. To reduce clinically meaningful confounding factors, we also conducted matched analyses.
Results
In the population‐based cohort, the incidence rate and standardized incidence ratio of PAD in UC patients were 3.74/1000 person‐years (95% confidence interval, 3.25–4.31) and 2.88 (95% confidence interval, 2.50–3.32), respectively. In the hospital‐based cohort, the cumulative probabilities of PAD at 1, 5, 10, and 20 years after diagnosis were 1.0%, 2.3%, 4.0%, and 6.3%, respectively. In both population‐based and hospital‐based cohorts, UC patients with PAD showed higher proportions of corticosteroid use and extensive colitis at diagnosis. The requirements for anti‐tumor necrosis factor agents and colectomy were significantly higher in UC patients with PAD before and after matched analysis.
Conclusions
The risk of PAD is higher in UC patients than in the general population. UC patients with PAD have distinct clinical features and poor outcomes, as indicated by the greater need for UC‐related medications and colectomy.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.14555</identifier><identifier>PMID: 30549125</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adrenal Cortex Hormones - adverse effects ; Adult ; Aged ; anus diseases ; Anus Diseases - epidemiology ; Anus Diseases - etiology ; Child ; Child, Preschool ; Cohort Studies ; Colectomy - statistics & numerical data ; Colitis, Ulcerative - complications ; Colitis, Ulcerative - epidemiology ; Confidence intervals ; Corticosteroids ; Diagnosis ; Drug Utilization - statistics & numerical data ; Female ; fistula ; Health risk assessment ; Hospitals - statistics & numerical data ; Humans ; Incidence ; Infant ; Inflammatory bowel disease ; Male ; Middle Aged ; Patients ; Population ; Population studies ; Population-based studies ; Prognosis ; Republic of Korea - epidemiology ; Risk ; Time Factors ; Tumor Necrosis Factor-alpha - antagonists & inhibitors ; Ulcerative colitis ; Young Adult</subject><ispartof>Journal of gastroenterology and hepatology, 2019-06, Vol.34 (6), p.1011-1017</ispartof><rights>2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><rights>2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><rights>2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3535-57a953c267757805fde2386d1c9251c6ac1f410d95b552d6a21e1d3e1d9eaeac3</citedby><cites>FETCH-LOGICAL-c3535-57a953c267757805fde2386d1c9251c6ac1f410d95b552d6a21e1d3e1d9eaeac3</cites><orcidid>0000-0003-4845-9809</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.14555$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.14555$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30549125$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Song, Eun Mi</creatorcontrib><creatorcontrib>Lee, Ho‐Su</creatorcontrib><creatorcontrib>Kim, Ye‐Jee</creatorcontrib><creatorcontrib>Oh, Eun Hye</creatorcontrib><creatorcontrib>Ham, Nam Seok</creatorcontrib><creatorcontrib>Kim, Jeongseok</creatorcontrib><creatorcontrib>Hwang, Sung Wook</creatorcontrib><creatorcontrib>Park, Sang Hyoung</creatorcontrib><creatorcontrib>Yang, Dong‐Hoon</creatorcontrib><creatorcontrib>Ye, Byong Duk</creatorcontrib><creatorcontrib>Byeon, Jeong‐Sik</creatorcontrib><creatorcontrib>Myung, Seung‐Jae</creatorcontrib><creatorcontrib>Yang, Suk‐Kyun</creatorcontrib><title>Incidence and clinical impact of perianal disease in patients with ulcerative colitis: A nationwide population‐based study</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
The risk and clinical impact of perianal disease (PAD) in ulcerative colitis (UC) patients have not been fully evaluated. We investigated the incidence of PAD in UC patients and compared clinical characteristics and outcomes of UC according to the presence of PAD.
Methods
We performed a nationwide population‐based cohort study and a hospital‐based cohort study. Using the 2010–2014 data from the Korean National Health Insurance claims database, we calculated incidence rates and standardized incidence ratios of PAD in UC patients compared with the general population. We evaluated the clinical characteristics and outcomes of UC patients with PAD in both population‐based and hospital‐based cohorts. To reduce clinically meaningful confounding factors, we also conducted matched analyses.
Results
In the population‐based cohort, the incidence rate and standardized incidence ratio of PAD in UC patients were 3.74/1000 person‐years (95% confidence interval, 3.25–4.31) and 2.88 (95% confidence interval, 2.50–3.32), respectively. In the hospital‐based cohort, the cumulative probabilities of PAD at 1, 5, 10, and 20 years after diagnosis were 1.0%, 2.3%, 4.0%, and 6.3%, respectively. In both population‐based and hospital‐based cohorts, UC patients with PAD showed higher proportions of corticosteroid use and extensive colitis at diagnosis. The requirements for anti‐tumor necrosis factor agents and colectomy were significantly higher in UC patients with PAD before and after matched analysis.
Conclusions
The risk of PAD is higher in UC patients than in the general population. UC patients with PAD have distinct clinical features and poor outcomes, as indicated by the greater need for UC‐related medications and colectomy.</description><subject>Adolescent</subject><subject>Adrenal Cortex Hormones - adverse effects</subject><subject>Adult</subject><subject>Aged</subject><subject>anus diseases</subject><subject>Anus Diseases - epidemiology</subject><subject>Anus Diseases - etiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Colectomy - statistics & numerical data</subject><subject>Colitis, Ulcerative - complications</subject><subject>Colitis, Ulcerative - epidemiology</subject><subject>Confidence intervals</subject><subject>Corticosteroids</subject><subject>Diagnosis</subject><subject>Drug Utilization - statistics & numerical data</subject><subject>Female</subject><subject>fistula</subject><subject>Health risk assessment</subject><subject>Hospitals - statistics & numerical data</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Inflammatory bowel disease</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Population</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prognosis</subject><subject>Republic of Korea - epidemiology</subject><subject>Risk</subject><subject>Time Factors</subject><subject>Tumor Necrosis Factor-alpha - antagonists & inhibitors</subject><subject>Ulcerative colitis</subject><subject>Young Adult</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1KxDAURoMoOo4ufAEJuHJRTZrc_riTQWcUwY2uSya51QydtDatw4ALH8Fn9EmMU3XnhXDJx-HA_Qg54uyMhzlfPD2fcQkAW2TEpWQRT2WyTUYs4xDlgud7ZN_7BWNMshR2yZ5gIHMew4i83ThtDTqNVDlDdWWd1aqidtko3dG6pA22VrkQGetReaTW0UZ1Fl3n6cp2z7SvNLYheUWq68p21l_QS-pCUrtVkNOmbvpq8_18_5gHh6G-6836gOyUqvJ4-LPH5PH66mEyi-7upzeTy7tICxAQQapyEDpO0hTSjEFpMBZZYrjOY-A6UZqXkjOTwxwgNomKOXIjwstRodJiTE4Gb9PWLz36rljUfRtu8kUcCyllxmUaqNOB0m3tfYtl0bR2qdp1wVnx3XMRei42PQf2-MfYz5do_sjfYgNwPgArW-H6f1NxO50Nyi_zF4l2</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Song, Eun Mi</creator><creator>Lee, Ho‐Su</creator><creator>Kim, Ye‐Jee</creator><creator>Oh, Eun Hye</creator><creator>Ham, Nam Seok</creator><creator>Kim, Jeongseok</creator><creator>Hwang, Sung Wook</creator><creator>Park, Sang Hyoung</creator><creator>Yang, Dong‐Hoon</creator><creator>Ye, Byong Duk</creator><creator>Byeon, Jeong‐Sik</creator><creator>Myung, Seung‐Jae</creator><creator>Yang, Suk‐Kyun</creator><general>Wiley Subscription Services, Inc</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>7T5</scope><scope>7U9</scope><scope>H94</scope><orcidid>https://orcid.org/0000-0003-4845-9809</orcidid></search><sort><creationdate>201906</creationdate><title>Incidence and clinical impact of perianal disease in patients with ulcerative colitis: A nationwide population‐based study</title><author>Song, Eun Mi ; Lee, Ho‐Su ; Kim, Ye‐Jee ; Oh, Eun Hye ; Ham, Nam Seok ; Kim, Jeongseok ; Hwang, Sung Wook ; Park, Sang Hyoung ; Yang, Dong‐Hoon ; Ye, Byong Duk ; Byeon, Jeong‐Sik ; Myung, Seung‐Jae ; Yang, Suk‐Kyun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3535-57a953c267757805fde2386d1c9251c6ac1f410d95b552d6a21e1d3e1d9eaeac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adrenal Cortex Hormones - adverse effects</topic><topic>Adult</topic><topic>Aged</topic><topic>anus diseases</topic><topic>Anus Diseases - epidemiology</topic><topic>Anus Diseases - etiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Colectomy - statistics & numerical data</topic><topic>Colitis, Ulcerative - complications</topic><topic>Colitis, Ulcerative - epidemiology</topic><topic>Confidence intervals</topic><topic>Corticosteroids</topic><topic>Diagnosis</topic><topic>Drug Utilization - statistics & numerical data</topic><topic>Female</topic><topic>fistula</topic><topic>Health risk assessment</topic><topic>Hospitals - statistics & numerical data</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Inflammatory bowel disease</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Population</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Prognosis</topic><topic>Republic of Korea - epidemiology</topic><topic>Risk</topic><topic>Time Factors</topic><topic>Tumor Necrosis Factor-alpha - antagonists & inhibitors</topic><topic>Ulcerative colitis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Song, Eun Mi</creatorcontrib><creatorcontrib>Lee, Ho‐Su</creatorcontrib><creatorcontrib>Kim, Ye‐Jee</creatorcontrib><creatorcontrib>Oh, Eun Hye</creatorcontrib><creatorcontrib>Ham, Nam Seok</creatorcontrib><creatorcontrib>Kim, Jeongseok</creatorcontrib><creatorcontrib>Hwang, Sung Wook</creatorcontrib><creatorcontrib>Park, Sang Hyoung</creatorcontrib><creatorcontrib>Yang, Dong‐Hoon</creatorcontrib><creatorcontrib>Ye, Byong Duk</creatorcontrib><creatorcontrib>Byeon, Jeong‐Sik</creatorcontrib><creatorcontrib>Myung, Seung‐Jae</creatorcontrib><creatorcontrib>Yang, Suk‐Kyun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Song, Eun Mi</au><au>Lee, Ho‐Su</au><au>Kim, Ye‐Jee</au><au>Oh, Eun Hye</au><au>Ham, Nam Seok</au><au>Kim, Jeongseok</au><au>Hwang, Sung Wook</au><au>Park, Sang Hyoung</au><au>Yang, Dong‐Hoon</au><au>Ye, Byong Duk</au><au>Byeon, Jeong‐Sik</au><au>Myung, Seung‐Jae</au><au>Yang, Suk‐Kyun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and clinical impact of perianal disease in patients with ulcerative colitis: A nationwide population‐based study</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2019-06</date><risdate>2019</risdate><volume>34</volume><issue>6</issue><spage>1011</spage><epage>1017</epage><pages>1011-1017</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
The risk and clinical impact of perianal disease (PAD) in ulcerative colitis (UC) patients have not been fully evaluated. We investigated the incidence of PAD in UC patients and compared clinical characteristics and outcomes of UC according to the presence of PAD.
Methods
We performed a nationwide population‐based cohort study and a hospital‐based cohort study. Using the 2010–2014 data from the Korean National Health Insurance claims database, we calculated incidence rates and standardized incidence ratios of PAD in UC patients compared with the general population. We evaluated the clinical characteristics and outcomes of UC patients with PAD in both population‐based and hospital‐based cohorts. To reduce clinically meaningful confounding factors, we also conducted matched analyses.
Results
In the population‐based cohort, the incidence rate and standardized incidence ratio of PAD in UC patients were 3.74/1000 person‐years (95% confidence interval, 3.25–4.31) and 2.88 (95% confidence interval, 2.50–3.32), respectively. In the hospital‐based cohort, the cumulative probabilities of PAD at 1, 5, 10, and 20 years after diagnosis were 1.0%, 2.3%, 4.0%, and 6.3%, respectively. In both population‐based and hospital‐based cohorts, UC patients with PAD showed higher proportions of corticosteroid use and extensive colitis at diagnosis. The requirements for anti‐tumor necrosis factor agents and colectomy were significantly higher in UC patients with PAD before and after matched analysis.
Conclusions
The risk of PAD is higher in UC patients than in the general population. UC patients with PAD have distinct clinical features and poor outcomes, as indicated by the greater need for UC‐related medications and colectomy.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30549125</pmid><doi>10.1111/jgh.14555</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4845-9809</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Adrenal Cortex Hormones - adverse effects Adult Aged anus diseases Anus Diseases - epidemiology Anus Diseases - etiology Child Child, Preschool Cohort Studies Colectomy - statistics & numerical data Colitis, Ulcerative - complications Colitis, Ulcerative - epidemiology Confidence intervals Corticosteroids Diagnosis Drug Utilization - statistics & numerical data Female fistula Health risk assessment Hospitals - statistics & numerical data Humans Incidence Infant Inflammatory bowel disease Male Middle Aged Patients Population Population studies Population-based studies Prognosis Republic of Korea - epidemiology Risk Time Factors Tumor Necrosis Factor-alpha - antagonists & inhibitors Ulcerative colitis Young Adult |
| title | Incidence and clinical impact of perianal disease in patients with ulcerative colitis: A nationwide population‐based study |
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