Background and Aim: The present study evaluated the clinical characteristics of Korean patients with Crohn's disease (CD) according to their age at diagnosis in a nationwide multicenter cohort study. Methods: A total of 1224 patients diagnosed with CD between 1982 and 2008 in 32 hospitals were included, and age at diagnosis was categorized as ≤ 16 (G1), 17–40 (G2), 41–59 (G3) and ≥ 60 (G4) years old. The baseline characteristics, medication, and intestinal resection were compared according to the age at diagnosis. Results: The number of patients in each age group was 155 (G1; 12.7%), 919 (G2; 75.1%), 120 (G3; 9.8%), and 30 (G4; 2.5%). The frequencies of ileocolonic disease in the late adult onset and elderly onset groups were lower than those in the other groups (P < 0.001). The cumulative probabilities of thiopurine and anti-tumor necrosis factor use in late adult onset and elderly onset groups were significantly reduced compared with those of the other groups (P < 0.01). However, the risk of the first intestinal resection was not different among the age groups. The ileal location (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.11–2.27), complicated behavior (HR: 3.35; 95% CI: 2.63–4.27), and early thiopurine use (HR: 0.27; 95% CI: 0.17–0.43) were associated with the first intestinal resection, whereas the age at diagnosis was not a risk factor. Conclusions: Elderly onset CD may be related to favorable outcomes in Korea. Thus, the heterogeneity of this disease should be considered when developing a tailored strategy for the treatment of CD.
|Number of pages||7|
|Journal||Journal of Gastroenterology and Hepatology (Australia)|
|Publication status||Published - 2017 Oct|
Bibliographical noteFunding Information:
Study population. A total of 1382 patients diagnosed with CD between 1982 and 2008 in 30 university hospitals and 2 local hospitals, which cover the majority of referral hospitals in Korea, were included in the CrOhn’s disease cliNical NEtwork and CohorT (CONNECT) study.12 This retrospective multicenter cohort study was conducted nationwide in Korea and performed by the Korean Association for the Study of Intestinal Diseases. This cohort study was supported by the Ministry for Health, Welfare and Family Affairs and Center for Disease Control in Korea. A diagnosis of CD was based on clinical, radiological, endoscopic, and histopathologic criteria,6,13,14 and all patients were diagnosed and treated by gastroenterologists who are members of Korean Association for the Study of Intestinal Diseases. Patients with the following were excluded: (i) condition diagnosed or suspected as indeterminate colitis, intestinal Behcet’s disease, intestinal tuberculosis, or infectious disease; (ii) follow-up period of less than 1 year (regardless of the date of diagnosis); and (iii) incomplete medical records. Because the CONNECT study originally recruited Koreans only, all participants were of Korean ethnicity.12 The study protocol was approved by the Ethics Committee of Seoul National University Hospital.
Ye BD, Koo HS, Huh KC, Cheon JH, Kim YS, Kim YH, Han DS, Kim WH, and Kim JS approved the final manuscript. Financial support: This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention (2016-E63001-00).
© 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
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