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Probability of Stom...
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Everhov, Åsa H.Karolinska Institutet
(author)
Probability of Stoma in Incident Patients With Crohn's Disease in Sweden 2003-2019 : A Population-based Study
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2021-10-07
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Oxford University Press,2022
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Numbers
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LIBRIS-ID:oai:DiVA.org:oru-94852
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-94852URI
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https://doi.org/10.1093/ibd/izab245DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-184975URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:149455088URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding agencies:Bengt Ihre Research FoundationBengt Ihre Research FellowshipStrategic Research Area Epidemiology program at Karolinska InstitutetÖstergötland County Council Linköping University (ALF)
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Funding Agencies|Karolinska Institutet (KI SOS); Bengt Ihre Research Foundation; Swedish Research Council; Strategic Research Area Epidemiology program at Karolinska Institutet; Stockholm County Council; Karolinska Institutet (ALF); Ostergotland County Council; Linkoping University (ALF); Bengt Ihre Research Fellowship
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BACKGROUND: Surgery rates in patients with Crohn's disease have decreased during the last few decades, and use of antitumor necrosis agents (anti-TNF) has increased. Whether these changes correlate with a decreased probability of stoma is unknown. The objective of this study was to investigate the incidence of stoma in patients with Crohn's disease over time.METHODS: Through linkage of national registers, we identified patients who were diagnosed with Crohn's disease in 2003-2014 and were followed through 2019. We compared formation and closure of stomas over the calendar periods of diagnosis (2003-2006, 2007-2010, and 2011-2014).RESULTS: In a nationwide cohort of 18,815 incident patients with a minimum 5 years of follow-up, 652 (3.5%) underwent formation of a stoma. This was mostly performed in conjunction with ileocolic resection (39%). The 5-year cumulative incidence of stoma formation was 2.5%, with no differences between calendar periods (P = .61). Less than half of the patients (44%) had their stoma reversed. Stomas were more common in elderly-onset compared with pediatric-onset disease: 5-year cumulative incidence 3.6% vs 1.3%. Ileostomies were most common (64%), and 24.5% of the patients who underwent stoma surgery had perianal disease at end of follow-up. Within 5 years of diagnosis, 0.8% of the incident patients had a permanent stoma, and 0.05% had undergone proctectomy. The time from diagnosis to start of anti-TNF treatment decreased over calendar periods (P < .001).CONCLUSIONS: Despite increasing use of anti-TNF and a low rate of proctectomy, the cumulative incidence of stoma formation within 5 years of Crohn's disease diagnosis has not decreased from 2003 to 2019.
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Kalman, Thordis DisaLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)diska37
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Söderling, JonasKarolinska Institutet
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Nordenvall, CarolineKarolinska Institutet
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Halfvarson, Jonas,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology,Orebro Univ, Sweden(Swepub:oru)jshn
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Ekbom, AndersKarolinska Institutet
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Ludvigsson, Jonas F.,1969-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA,Karolinska Inst, Sweden; Orebro Univ, Sweden; Univ Nottingham, England; Columbia Univ Coll Phys & Surg, NY USA(Swepub:oru)jsln
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Olén, OlaKarolinska Institutet
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Myrelid, PärLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)parmy24
(author)
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Karolinska InstitutetAvdelningen för kirurgi, ortopedi och onkologi
(creator_code:org_t)
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