The changing face of Crohn’s disease: a population-based study of the natural history of Crohn’s disease in Örebro, Sweden 1963-2005

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Zhulina, Yaroslava,1973-Örebro universitet,Institutionen för hälsovetenskap och medicin,Department of Gastroenterology, , Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden (author)

The changing face of Crohn’s disease : a population-based study of the natural history of Crohn’s disease in Örebro, Sweden 1963-2005

Article/chapterEnglish2016

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2015-10-07
Oxon, United Kingdom :Taylor & Francis Group,2016
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LIBRIS-ID:oai:DiVA.org:oru-46323
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-46323URI
https://doi.org/10.3109/00365521.2015.1093167DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:132407975URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Funding Agencies:Örebro University Hospital Research Foundation OLL-256371Örebro County Research Foundation OLL-403371 OLL-457731
Objective: Changes in medical therapy and surgery might have influenced the natural history Crohn’s disease (CD). Our aim was to explore the short-term outcome of CD and to specifically assess trends in disease phenotype, medications and surgery in the first five years from diagnosis.Material and Methods: A population-based cohort comprising 472 CD patients diagnosed within the primary catchment area of Örebro University Hospital 1963-2005 were identified retrospectively and described. Data on medication, surgery, progression in disease location and behaviour, were extracted from the medical records. Patients were divided into three cohorts based on year of diagnosis.Results: The proportion of patients with complicated disease behaviour 5 years after diagnosis decreased from 54.4% (95%CI, 43.9-65.6) to 33.3% (27.4-40.0) in patients diagnosed 1963-1975 and 1991-2005, respectively (p=0.002), whereas the proportion of patients progressing to complicated disease behaviour was stable among those with non-stricturing, non-penetrating disease at diagnosis (p=0.435). The proportion of patients undergoing surgery decreased from 65.8% (55.4-76.0) to 34.6% (28.6-41.5) in patients diagnosed 1963-1975 and 1991-2005, respectively (p<0.001). The reduction in surgery preceded an increased use of immunomodulators and was explained by a decrease in surgery within three months from diagnosis (p=0.001).Conclusions: We observed a striking decrease in complicated disease behaviour and surgery five years after CD diagnosis, the latter largely due to a decrease in early surgery. Our findings suggest that the introduction of new treatments alone does not explain the reduction in surgery rates, the increasing proportion of patients with inflammatory disease at diagnosis also play an important role.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Gastroenterologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Gastroenterology and Hepatology hsv//eng
Crohn’s disease
natural history
surgery
Epidemiologi
Epidemiology

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Udumyan, Ruzan,1971-Örebro universitet,Institutionen för hälsovetenskap och medicin,Clinical Epidemiology and Biostatistics(Swepub:oru)run (author)
Tysk, Curt,1949-Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)ctk (author)
Montgomery, Scott,1961-Karolinska Institutet,Örebro universitet,Institutionen för hälsovetenskap och medicin,Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK,Clinical Epidemiology and Biostatistics(Swepub:oru)smy (author)
Halfvarson, Jonas,1970-Örebro universitet,Institutionen för läkarutbildning,Department of Gastroenterology, , Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden(Swepub:oru)jshn (author)
Örebro universitetInstitutionen för hälsovetenskap och medicin (creator_code:org_t)

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In:Scandinavian Journal of GastroenterologyOxon, United Kingdom : Taylor & Francis Group51:3, s. 304-3130036-55211502-7708

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