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[Clinical presentation and risk factors for surgery in Crohn's disease].

OBJECTIVE
To investigate the risk factors on initial surgery in Crohn's disease.


METHODS
The clinical data of 173 patients with Crohn's disease who were treated during 2010 and 2014 years in the Second Affiliated Hospital of Sun Yat-Sen University, were analyzed retrospectively. The patients who had received intestinal resection or whose initial symptoms occurred at least 5 years at the end of the follow-up were recruited. Montreal classification was used to evaluate lesion location and disease behavior. The risk factors of the initial surgery were analyzed by using Logistic regression model.


RESULTS
Eighty-five patients (49.1%) received intestinal resection in 5 years after the onset of symptoms. The result of univariate analysis showed that the probability of surgical treatment is high in patients who were male and those older than 40 years at diagnosis (P<0.05). Lesions involving upper digestive tract, stenosis and penetrating lesions were also the risk factors on initial surgery in Crohn's disease (P<0.05). The result of multivariate analysis showed the relative risk of initial surgery was increased in male gender (OR=2.02, 95%CI:1.04-3.92) and in those who were older than 40 years at diagnosis (OR=2.34,95%CI:1.05-5.22). However, in patients with Crohn's disease involving colon alone, the relative risk of initial surgery was decreased (OR=0.35, 95%CI:0.13-0.97).


CONCLUSION
Abdominal pain is the most common clinical presentation in Crohn's disease. Disease behavior and operation is closely related. Older than 40 years at diagnosis and male gender is high risk factor for surgery while colonic lesion alone is protective factor.