Evolution of disease phenotype in adult and pediatric onset Crohn's disease in a population-based cohort
To investigate the evolution of disease phenotype in adult and pediatric onset Crohn's disease (CD) populations, diagnosed between 1977 and 2008. Data of 506 incident CD patients were analyzed (age at diagnosis: 28.5 years, interquartile range: 22-38 years). Both in- and outpatient records were...
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creator | Lovasz, Barbara Dorottya Lakatos, Laszlo Horvath, Agnes Szita, Istvan Pandur, Tunde Mandel, Michael Vegh, Zsuzsanna Golovics, Petra Anna Mester, Gabor Balogh, Mihaly Molnar, Csaba Komaromi, Erzsebet Kiss, Lajos Sandor Lakatos, Peter Laszlo |
description | To investigate the evolution of disease phenotype in adult and pediatric onset Crohn's disease (CD) populations, diagnosed between 1977 and 2008.
Data of 506 incident CD patients were analyzed (age at diagnosis: 28.5 years, interquartile range: 22-38 years). Both in- and outpatient records were collected prospectively with a complete clinical follow-up and comprehensively reviewed in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008 in adult and pediatric onset CD populations. Disease phenotype according to the Montreal classification and long-term disease course was analysed according to the age at onset in time-dependent univariate and multivariate analysis.
Among this population-based cohort, seventy-four (12.8%) pediatric-onset CD patients were identified (diagnosed ≤ 17 years of age). There was no significant difference in the distribution of disease behavior between pediatric (B1: 62%, B2: 15%, B3: 23%) and adult-onset CD patients (B1: 56%, B2: 21%, B3: 23%) at diagnosis, or during follow-up. Overall, the probability of developing complicated disease behaviour was 49.7% and 61.3% in the pediatric and 55.1% and 62.4% in the adult onset patients after 5- and 10-years of follow-up. Similarly, time to change in disease behaviour from non stricturing, non penetrating (B1) to complicated, stricturing or penetrating (B2/B3) disease was not significantly different between pediatric and adult onset CD in a Kaplan-Meier analysis. Calendar year of diagnosis (P = 0.04), ileal location (P < 0.001), perianal disease (P < 0.001), smoking (P = 0.038) and need for steroids (P < 0.001) were associated with presence of, or progression to, complicated disease behavior at diagnosis and during follow-up. A change in disease location was observed in 8.9% of patients and it was associated with smoking status (P = 0.01), but not with age at diagnosis.
Long-term evolution of disease behavior was not different in pediatric- and adult-onset CD patients in this population-based cohort but was associated to location, perianal disease and smoking status. |
doi_str_mv | 10.3748/wjg.v19.i14.2217 |
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Data of 506 incident CD patients were analyzed (age at diagnosis: 28.5 years, interquartile range: 22-38 years). Both in- and outpatient records were collected prospectively with a complete clinical follow-up and comprehensively reviewed in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008 in adult and pediatric onset CD populations. Disease phenotype according to the Montreal classification and long-term disease course was analysed according to the age at onset in time-dependent univariate and multivariate analysis.
Among this population-based cohort, seventy-four (12.8%) pediatric-onset CD patients were identified (diagnosed ≤ 17 years of age). There was no significant difference in the distribution of disease behavior between pediatric (B1: 62%, B2: 15%, B3: 23%) and adult-onset CD patients (B1: 56%, B2: 21%, B3: 23%) at diagnosis, or during follow-up. Overall, the probability of developing complicated disease behaviour was 49.7% and 61.3% in the pediatric and 55.1% and 62.4% in the adult onset patients after 5- and 10-years of follow-up. Similarly, time to change in disease behaviour from non stricturing, non penetrating (B1) to complicated, stricturing or penetrating (B2/B3) disease was not significantly different between pediatric and adult onset CD in a Kaplan-Meier analysis. Calendar year of diagnosis (P = 0.04), ileal location (P < 0.001), perianal disease (P < 0.001), smoking (P = 0.038) and need for steroids (P < 0.001) were associated with presence of, or progression to, complicated disease behavior at diagnosis and during follow-up. A change in disease location was observed in 8.9% of patients and it was associated with smoking status (P = 0.01), but not with age at diagnosis.
Long-term evolution of disease behavior was not different in pediatric- and adult-onset CD patients in this population-based cohort but was associated to location, perianal disease and smoking status.</description><identifier>ISSN: 1007-9327</identifier><identifier>EISSN: 2219-2840</identifier><identifier>DOI: 10.3748/wjg.v19.i14.2217</identifier><identifier>PMID: 23599648</identifier><language>eng</language><publisher>United States: Baishideng Publishing Group Co., Limited</publisher><subject>Adolescent ; Adult ; Age of Onset ; Brief ; Chi-Square Distribution ; Crohn Disease - diagnosis ; Crohn Disease - epidemiology ; Crohn Disease - therapy ; Disease Progression ; Female ; Humans ; Hungary - epidemiology ; Incidence ; Kaplan-Meier Estimate ; Male ; Multivariate Analysis ; Odds Ratio ; Phenotype ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Smoking - adverse effects ; Smoking - epidemiology ; Time Factors ; Young Adult</subject><ispartof>World journal of gastroenterology : WJG, 2013, Vol.19 (14), p.2217-2226</ispartof><rights>2013 Baishideng Publishing Group Co., Limited. All rights reserved. 2013</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-340c30d725f72ca130494db7baf151b6723af07527285cac7abcb8db3761c3b03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627886/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627886/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,729,782,786,887,4026,27930,27931,27932,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23599648$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lovasz, Barbara Dorottya</creatorcontrib><creatorcontrib>Lakatos, Laszlo</creatorcontrib><creatorcontrib>Horvath, Agnes</creatorcontrib><creatorcontrib>Szita, Istvan</creatorcontrib><creatorcontrib>Pandur, Tunde</creatorcontrib><creatorcontrib>Mandel, Michael</creatorcontrib><creatorcontrib>Vegh, Zsuzsanna</creatorcontrib><creatorcontrib>Golovics, Petra Anna</creatorcontrib><creatorcontrib>Mester, Gabor</creatorcontrib><creatorcontrib>Balogh, Mihaly</creatorcontrib><creatorcontrib>Molnar, Csaba</creatorcontrib><creatorcontrib>Komaromi, Erzsebet</creatorcontrib><creatorcontrib>Kiss, Lajos Sandor</creatorcontrib><creatorcontrib>Lakatos, Peter Laszlo</creatorcontrib><title>Evolution of disease phenotype in adult and pediatric onset Crohn's disease in a population-based cohort</title><title>World journal of gastroenterology : WJG</title><addtitle>World J Gastroenterol</addtitle><description>To investigate the evolution of disease phenotype in adult and pediatric onset Crohn's disease (CD) populations, diagnosed between 1977 and 2008.
Data of 506 incident CD patients were analyzed (age at diagnosis: 28.5 years, interquartile range: 22-38 years). Both in- and outpatient records were collected prospectively with a complete clinical follow-up and comprehensively reviewed in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008 in adult and pediatric onset CD populations. Disease phenotype according to the Montreal classification and long-term disease course was analysed according to the age at onset in time-dependent univariate and multivariate analysis.
Among this population-based cohort, seventy-four (12.8%) pediatric-onset CD patients were identified (diagnosed ≤ 17 years of age). There was no significant difference in the distribution of disease behavior between pediatric (B1: 62%, B2: 15%, B3: 23%) and adult-onset CD patients (B1: 56%, B2: 21%, B3: 23%) at diagnosis, or during follow-up. Overall, the probability of developing complicated disease behaviour was 49.7% and 61.3% in the pediatric and 55.1% and 62.4% in the adult onset patients after 5- and 10-years of follow-up. Similarly, time to change in disease behaviour from non stricturing, non penetrating (B1) to complicated, stricturing or penetrating (B2/B3) disease was not significantly different between pediatric and adult onset CD in a Kaplan-Meier analysis. Calendar year of diagnosis (P = 0.04), ileal location (P < 0.001), perianal disease (P < 0.001), smoking (P = 0.038) and need for steroids (P < 0.001) were associated with presence of, or progression to, complicated disease behavior at diagnosis and during follow-up. A change in disease location was observed in 8.9% of patients and it was associated with smoking status (P = 0.01), but not with age at diagnosis.
Long-term evolution of disease behavior was not different in pediatric- and adult-onset CD patients in this population-based cohort but was associated to location, perianal disease and smoking status.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age of Onset</subject><subject>Brief</subject><subject>Chi-Square Distribution</subject><subject>Crohn Disease - diagnosis</subject><subject>Crohn Disease - epidemiology</subject><subject>Crohn Disease - therapy</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Humans</subject><subject>Hungary - epidemiology</subject><subject>Incidence</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Phenotype</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Smoking - adverse effects</subject><subject>Smoking - epidemiology</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>1007-9327</issn><issn>2219-2840</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc1P3DAQxa2qVVk-7pyQb-WSre1J4viCVK2AVkLqBc6Wv0KMsnawnUX892QFrNrTk2beezPSD6FzStbA6-7ny9PjekfF2tN6zRjlX9BqEVGxriZf0YoSwisBjB-h45yfCGEADfuOjhg0QrR1t0LD9S6Oc_Ex4Nhj67NT2eFpcCGW18lhH7Cy81iwChZPznpVkjc4huwK3qQ4hB_5ENub8RSneVT7xkovQ4tNHGIqp-hbr8bszj70BD3cXN9vfld3f2__bH7dVQZEWyqoiQFiOWt6zoyiQGpRW8216mlDdcsZqJ7whnHWNUYZrrTRndXAW2pAEzhBV--906y3zhoXSlKjnJLfqvQqo_Ly_03wg3yMOwkt413XLgWXHwUpPs8uF7n12bhxVMHFOUsKQIkgouOLlbxbTYo5J9cfzlAi94DkAkgugOQCSO4BLZGLf987BD6JwBu3W4_g</recordid><startdate>2013</startdate><enddate>2013</enddate><creator>Lovasz, Barbara Dorottya</creator><creator>Lakatos, Laszlo</creator><creator>Horvath, Agnes</creator><creator>Szita, Istvan</creator><creator>Pandur, Tunde</creator><creator>Mandel, Michael</creator><creator>Vegh, Zsuzsanna</creator><creator>Golovics, Petra Anna</creator><creator>Mester, Gabor</creator><creator>Balogh, Mihaly</creator><creator>Molnar, Csaba</creator><creator>Komaromi, Erzsebet</creator><creator>Kiss, Lajos Sandor</creator><creator>Lakatos, Peter Laszlo</creator><general>Baishideng Publishing Group Co., Limited</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>7X8</scope><scope>5PM</scope></search><sort><creationdate>2013</creationdate><title>Evolution of disease phenotype in adult and pediatric onset Crohn's disease in a population-based cohort</title><author>Lovasz, Barbara Dorottya ; Lakatos, Laszlo ; Horvath, Agnes ; Szita, Istvan ; Pandur, Tunde ; Mandel, Michael ; Vegh, Zsuzsanna ; Golovics, Petra Anna ; Mester, Gabor ; Balogh, Mihaly ; Molnar, Csaba ; Komaromi, Erzsebet ; Kiss, Lajos Sandor ; Lakatos, Peter Laszlo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-340c30d725f72ca130494db7baf151b6723af07527285cac7abcb8db3761c3b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age of Onset</topic><topic>Brief</topic><topic>Chi-Square Distribution</topic><topic>Crohn Disease - diagnosis</topic><topic>Crohn Disease - epidemiology</topic><topic>Crohn Disease - therapy</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Humans</topic><topic>Hungary - epidemiology</topic><topic>Incidence</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Phenotype</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Smoking - adverse effects</topic><topic>Smoking - epidemiology</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>online_resources</toplevel><creatorcontrib>Lovasz, Barbara Dorottya</creatorcontrib><creatorcontrib>Lakatos, Laszlo</creatorcontrib><creatorcontrib>Horvath, Agnes</creatorcontrib><creatorcontrib>Szita, Istvan</creatorcontrib><creatorcontrib>Pandur, Tunde</creatorcontrib><creatorcontrib>Mandel, Michael</creatorcontrib><creatorcontrib>Vegh, Zsuzsanna</creatorcontrib><creatorcontrib>Golovics, Petra Anna</creatorcontrib><creatorcontrib>Mester, Gabor</creatorcontrib><creatorcontrib>Balogh, Mihaly</creatorcontrib><creatorcontrib>Molnar, Csaba</creatorcontrib><creatorcontrib>Komaromi, Erzsebet</creatorcontrib><creatorcontrib>Kiss, Lajos Sandor</creatorcontrib><creatorcontrib>Lakatos, Peter Laszlo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of gastroenterology : WJG</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lovasz, Barbara Dorottya</au><au>Lakatos, Laszlo</au><au>Horvath, Agnes</au><au>Szita, Istvan</au><au>Pandur, Tunde</au><au>Mandel, Michael</au><au>Vegh, Zsuzsanna</au><au>Golovics, Petra Anna</au><au>Mester, Gabor</au><au>Balogh, Mihaly</au><au>Molnar, Csaba</au><au>Komaromi, Erzsebet</au><au>Kiss, Lajos Sandor</au><au>Lakatos, Peter Laszlo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolution of disease phenotype in adult and pediatric onset Crohn's disease in a population-based cohort</atitle><jtitle>World journal of gastroenterology : WJG</jtitle><addtitle>World J Gastroenterol</addtitle><date>2013</date><risdate>2013</risdate><volume>19</volume><issue>14</issue><spage>2217</spage><epage>2226</epage><pages>2217-2226</pages><issn>1007-9327</issn><eissn>2219-2840</eissn><abstract>To investigate the evolution of disease phenotype in adult and pediatric onset Crohn's disease (CD) populations, diagnosed between 1977 and 2008.
Data of 506 incident CD patients were analyzed (age at diagnosis: 28.5 years, interquartile range: 22-38 years). Both in- and outpatient records were collected prospectively with a complete clinical follow-up and comprehensively reviewed in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008 in adult and pediatric onset CD populations. Disease phenotype according to the Montreal classification and long-term disease course was analysed according to the age at onset in time-dependent univariate and multivariate analysis.
Among this population-based cohort, seventy-four (12.8%) pediatric-onset CD patients were identified (diagnosed ≤ 17 years of age). There was no significant difference in the distribution of disease behavior between pediatric (B1: 62%, B2: 15%, B3: 23%) and adult-onset CD patients (B1: 56%, B2: 21%, B3: 23%) at diagnosis, or during follow-up. Overall, the probability of developing complicated disease behaviour was 49.7% and 61.3% in the pediatric and 55.1% and 62.4% in the adult onset patients after 5- and 10-years of follow-up. Similarly, time to change in disease behaviour from non stricturing, non penetrating (B1) to complicated, stricturing or penetrating (B2/B3) disease was not significantly different between pediatric and adult onset CD in a Kaplan-Meier analysis. Calendar year of diagnosis (P = 0.04), ileal location (P < 0.001), perianal disease (P < 0.001), smoking (P = 0.038) and need for steroids (P < 0.001) were associated with presence of, or progression to, complicated disease behavior at diagnosis and during follow-up. A change in disease location was observed in 8.9% of patients and it was associated with smoking status (P = 0.01), but not with age at diagnosis.
Long-term evolution of disease behavior was not different in pediatric- and adult-onset CD patients in this population-based cohort but was associated to location, perianal disease and smoking status.</abstract><cop>United States</cop><pub>Baishideng Publishing Group Co., Limited</pub><pmid>23599648</pmid><doi>10.3748/wjg.v19.i14.2217</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adult Age of Onset Brief Chi-Square Distribution Crohn Disease - diagnosis Crohn Disease - epidemiology Crohn Disease - therapy Disease Progression Female Humans Hungary - epidemiology Incidence Kaplan-Meier Estimate Male Multivariate Analysis Odds Ratio Phenotype Prognosis Proportional Hazards Models Prospective Studies Risk Factors Smoking - adverse effects Smoking - epidemiology Time Factors Young Adult |
title | Evolution of disease phenotype in adult and pediatric onset Crohn's disease in a population-based cohort |
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