Comparative Study on the Management and Outcomes of Postoperative Crohn's Disease in Older Patients

Limited data are available on the management and outcomes of postoperative Crohn's disease (CD) in older patients. We aimed to describe the management of CD in the postoperative setting and assess surgical postoperative recurrence (POR) in this population. This was a case-control study includin...

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Detalhes bibliográficos
Autores: Mañosa i Ciria, Míriam|||0000-0002-9051-2581, Calafat, Margalida|||0000-0003-2335-3792, Ricart, Elena, Nos, Pilar|||0000-0002-6619-1511, Iglesias-Flores, Eva, Riestra, Sabino|||0000-0002-9383-3698, Mesonero, Francisco|||0000-0002-7864-8187, Calvo, Marta, Guardiola, Jordi|||0000-0002-0464-241X, Hernández, Vicent|||0000-0003-1607-0831, Rivero, Montserrat|||0000-0002-5834-1559, Carpio, Daniel|||0000-0001-7929-1151, Mínguez, Miguel|||0000-0003-0148-5938, Alba, Cristina, Martín-Arranz, María Dolores|||0000-0002-1872-0917, Vela, Milagros|||0000-0003-4537-9133, Gomollón, Fernando|||0000-0003-0076-3529, García-López, Santiago|||0000-0003-3970-5457, Gutiérrez Casbas, Ana|||0000-0002-5460-4139, Calvet, Xavier|||0000-0002-6278-9663, González Muñoza, Carlos|||0000-0003-0164-3449, Barrio, Jesús|||0000-0001-7087-3921, P. Gisbert, Javier|||0000-0003-2090-3445, Sicilia Aladrén, Beatriz|||0000-0002-4495-9358, Pérez-Calle, José Lázaro|||0000-0002-8724-2760, Bujanda, Luis|||0000-0002-4353-9968, Esteve, Maria|||0000-0001-7716-0027, Ramos López, Laura|||0000-0001-7015-1742, Varela, Pilar|||0000-0003-1737-3236, Sierra Ausín, Mónica|||0000-0003-3342-8209, Merino, Olga|||0000-0002-1362-4475, Bermejo, Fernando|||0000-0003-4610-0886, Barreiro de-Acosta, Manuel|||0000-0001-5915-1477, Perez, Antonio Rodríguez, Márquez Mosquera, Lucía|||0000-0002-3182-9570, García-Bosch, Orlando, Rodríguez-Lago, Iago|||0000-0003-1133-4578, Lorente Poyatos, Rufo|||0000-0003-0709-2932, García-Sepulcre, Mariana Fe|||0000-0002-1329-9529, Maroto, Nuria, Vega Villaamil, Pablo|||0000-0001-7545-6297, Monfort, David, San Martín, Lucía Zabalsa, Busquets, David|||0000-0002-9385-1415, Martínez Montiel, Pilar|||0000-0002-8688-8244, Riera, Joan, Alcain, Guillermo, Llaó, Jordina, Marin, Nacho, Marín Jiménez, Ignacio|||0000-0001-5424-2484, Sesé Abizanda, Eva, Van Domselaar, Manuel|||0000-0002-9950-2216, Huguet, José M°, Ginard, Daniel, Bas-Cutrina, Francesc|||0000-0002-6621-4509, Ber, Yolanda|||0000-0002-5184-8349, Roncero, Oscar, Lucendo, Alfredo J.|||0000-0003-1183-1072, López-García, Alicia|||0000-0001-9268-4259, Menacho, Margarita, Almela, Pedro, Ponferrada Díaz, Ángel|||0000-0002-1176-276X, Coronel, Ana Fuentes, Maestro, Sergio, de Jesús Martínez-Pérez, Teresa, Vilafranca, Carmen Muñoz, Argüelles-Arias, Federico|||0000-0003-3646-8919, Legido, Jesús, Gilabert, Pau, Charro, Mara, Trapero, Ana M., Fernández, Hipólito, Frago, Santiago, Hernández Villalba, Luis|||0000-0002-9175-4312, Muñoz, Esther, Domènech, Eugeni|||0000-0002-2315-7196
Formato: artículo
Fecha de publicación:2025
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:326276
Acesso em linha:https://ddd.uab.cat/record/326276
https://dx.doi.org/urn:doi:10.1002/ueg2.70150
Access Level:acceso abierto
Palavra-chave:Crohn's disease
Older
Postoperative recurrence
Surgery
Descrição
Resumo:Limited data are available on the management and outcomes of postoperative Crohn's disease (CD) in older patients. We aimed to describe the management of CD in the postoperative setting and assess surgical postoperative recurrence (POR) in this population. This was a case-control study including all adult patients with CD from the ENEIDA registry who had undergone a first intestinal resection with ileo-colonic anastomosis. Patients were grouped according to their age at the time of the first surgery in older (over 60 years) subjects and controls (between 18 and 60 years of age). A total of 3982 (535 older subjects and 3454 controls) underwent a first intestinal resection for CD with an ileo-colonic anastomosis. Time from CD diagnosis to surgery was significantly longer in older patients (114 ± 128 vs. 93 ± 97 months; p < 0.001). Older patients also had a lower proportion of penetrating CD (25% vs. 39%; p < 0.0001) and perianal disease (14% vs.25%; p < 0.0001). A significantly lower proportion of older patients started preventive therapies for POR (32% vs. 51%; p < 0.0001). The cumulative risk of surgical POR was 3.2%, 5.3% and 10.1% in the older group and 3.6%, 6.6% and 14.2% in the control group at three, five and 10 years, respectively (p = 0.093). In the multivariate logistic regression analysis, only prevention with thiopurines was associated with a lower risk of surgical POR. Conclusions: Although postoperative preventive therapy with immunomodulators or biologicals is prescribed less often in older patients after a first intestinal resection, they develop surgical POR as often as younger adult patients.

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