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Real-World Experience with AGA Guidelines in the Management of Crohn’s Disease following Ileocolonic Resection: A Retrospective Cohort Study
Joint Authors
Cao, Qian
Tang, Shasha
Ge, Xiaolong
Zhou, Wei
Liu, Wei
Qi, Weilin
Yu, Tunan
Source
Gastroenterology Research and Practice
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-04-20
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
Postoperative endoscopic recurrence (PER) is common in patients with Crohn’s disease (CD) after surgery.
The impact of the American Gastroenterological Association (AGA) guideline adherence on PER in real life remains unclear.
Methods.
The postoperative management of CD patients undergoing ileocolonic resection with anastomosis from 2017 to 2018 was conducted based on the AGA guidelines.
Colonoscopies were performed within one year after surgery.
Clinical data and risk factors for endoscopic recurrence were analyzed focusing on postoperative pharmacological prophylaxis.
Results.
All patients were at a high risk of postoperative recurrence according to the AGA guidelines.
PER occurred in 29 (28.7%) of these patients.
The overall PER rate was 39.2% at one year.
The PER rate in patients treated with nitroimidazole, thiopurines, infliximab, or a combination of thiopurines and infliximab for postoperative prophylaxis was 88.1%, 34.1%, 20.5%, and 0%, respectively.
Cox regression showed that smoking at the time of surgery and AGA guideline adherence were independent factors associated with PER (HR: 3.75, 95% CI: 1.36-10.33, P=0.01; HR: 0.36, 95% CI: 0.15-0.86, P=0.02).
In addition, further investigation revealed that educational background was the main factor related to patients’ nonadherence to AGA guidelines.
Conclusions.
The majority of CD patients who undergo surgery in clinical practice may be at a high risk of disease recurrence.
Thiopurines and infliximab are effective in preventing endoscopic recurrence.
Guideline nonadherence is associated with PER at one year, thus indicating that there is room for improvement in adherence to the AGA guidelines.
American Psychological Association (APA)
Tang, Shasha& Liu, Wei& Qi, Weilin& Yu, Tunan& Cao, Qian& Ge, Xiaolong…[et al.]. 2020. Real-World Experience with AGA Guidelines in the Management of Crohn’s Disease following Ileocolonic Resection: A Retrospective Cohort Study. Gastroenterology Research and Practice،Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1167066
Modern Language Association (MLA)
Tang, Shasha…[et al.]. Real-World Experience with AGA Guidelines in the Management of Crohn’s Disease following Ileocolonic Resection: A Retrospective Cohort Study. Gastroenterology Research and Practice No. 2020 (2020), pp.1-6.
https://search.emarefa.net/detail/BIM-1167066
American Medical Association (AMA)
Tang, Shasha& Liu, Wei& Qi, Weilin& Yu, Tunan& Cao, Qian& Ge, Xiaolong…[et al.]. Real-World Experience with AGA Guidelines in the Management of Crohn’s Disease following Ileocolonic Resection: A Retrospective Cohort Study. Gastroenterology Research and Practice. 2020. Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1167066
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1167066