Comparative Study on the Management and Outcomes of Postoperative Crohn's Disease in Older Patients: Data From the ENEIDA Registry

ABSTRACT Background 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. Methods This was a...

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Detalles Bibliográficos
Autores: Mañosa, Míriam, Calafat, Margalida, Ricart, Elena, Nos, Pilar, Iglesias, Eva, Riestra, Sabino, Mesonero, Francisco, Calvo, Marta, Guardiola, Jordi, Hernández, Vicent, Rivero, Montserrat, Carpio, Daniel, Mínguez, Miguel, Alba, Cristina, Martín‐Arranz, Maria Dolores, Vela, Milagros, Gomollón, Fernando, García‐López, Santiago, Casbas, Ana Gutiérrez, Calvet, Xavier, González‐Muñoza, Carlos, Barrio, Jesús, Gisbert, Javier P., Sicilia, Beatriz, Pérez‐Calle, José Lázaro, Bujanda, Luis, Esteve, Maria, Ramos, Laura, Varela, Pilar, Sierra, Mónica, Merino, Olga, Bermejo, Fernando, Barreiro‐de Acosta, Manuel, Perez, Antonio Rodríguez, Márquez‐Mosquera, Lucía, García‐Bosch, Orlando, Rodríguez‐Lago, Iago, Lorente Poyatos, Rufo H., García Sepulcre, Mariana Fe, Maroto, Nuria, Vega, Pablo, Monfort, David, San Martín, Lucía Zabalsa, Busquets, David, Martinez‐Montiel, Pilar, Riera-Oliver, Joan, Alcain, Guillermo, Llaó, Jordina, Marin, Nacho, Marin‐Jimenez, Ignacio, Sesé, Eva, Van Domselaar, Manuel, Huguet, José M°, Ginard-Vicens, Daniel, Bas‐Cutrina, Francesc, Ber, Yolanda, Roncero, Oscar, Lucendo, Alfredo J., López‐García, Alicia, Menacho, Margarita, Almela, Pedro, Ponferrada, Ángel, Coronel, Ana Fuentes, Maestro, Sergio, de Jesús Martínez‐Pérez, Teresa, Vilafranca, Carmen Muñoz, Argüelles, Federico, Legido, Jesús, Gilabert, Pau, Charro, Mara, Trapero, Ana M., Fernández, Hipólito, Frago, Santiago, Villalba, Luis Hernández, Muñoz, Esther, Domènech, Eugeni
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/26470
Acceso en línea:https://hdl.handle.net/20.500.13003/26470
Access Level:acceso abierto
Palabra clave:Crohn Disease
Postoperative Care
General Surgery
Adult
Age Factors
Aged
Anastomosis, Surgical
Case-Control Studies
Colectomy
Ileum
Immunosuppressive Agents
Postoperative Complications
Recurrence
Treatment Outcome
Enfermedad de Crohn
Cuidados Posoperatorios
Cirugía General
Adulto
Factores de Edad
Anciano
Anastomosis Quirúrgica
Estudios de Casos y Controles
Colectomía
Íleon
Inmunosupresores
Complicaciones Posoperatorias
Recurrencia
Resultado del Tratamiento
Crohn's disease
older
postoperative recurrence
surgery
Descripción
Sumario:ABSTRACT Background 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. Methods 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). Results 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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