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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 ...

  • 2021-10-07
  • Oxford University Press,2022
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:oru-94852
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-94852URI
  • https://doi.org/10.1093/ibd/izab245DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-184975URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:149455088URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding agencies:Bengt Ihre Research FoundationBengt Ihre Research FellowshipStrategic Research Area Epidemiology program at Karolinska InstitutetÖstergötland County Council Linköping University (ALF)
  • 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
  • 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.

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  • Kalman, Thordis DisaLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)diska37 (author)
  • Söderling, JonasKarolinska Institutet (author)
  • Nordenvall, CarolineKarolinska Institutet (author)
  • Halfvarson, Jonas,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology,Orebro Univ, Sweden(Swepub:oru)jshn (author)
  • Ekbom, AndersKarolinska Institutet (author)
  • 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 (author)
  • Olén, OlaKarolinska Institutet (author)
  • Myrelid, PärLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)parmy24 (author)
  • Karolinska InstitutetAvdelningen för kirurgi, ortopedi och onkologi (creator_code:org_t)

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