Incidence Rates for Surgery in Crohn’s Disease Have Decreased: A Population-based Time-trend Analysis

2020 ◽  
Vol 26 (12) ◽  
pp. 1909-1916 ◽  
Author(s):  
Alexandra E Dittrich ◽  
Reed Taylor Sutton ◽  
Kate Haynes ◽  
Haili Wang ◽  
Richard N Fedorak ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Trend Analysis ◽  
Time Trend ◽  
Population Level ◽  
Population Based ◽  
Incidence Rates ◽  
Annual Percent Change ◽  
Related Data ◽  
Smoking Trends

Abstract Background Many Crohn’s disease (CD) patients will undergo surgery over the course of their life. It is thought that with the introduction of disease-modifying agents like anti-TNF therapy, there would be a population-level decrease in the need for surgery. This time-trend study aimed to assess the changes in surgical rates following the induction of anti-TNF therapy. Methods Adult CD patients who underwent abdominal surgery (identified by administrative coding) between January of 1996 and December of 2013 at 1 of the 4 Edmonton-area hospitals were included. Patient charts were manually reviewed to confirm diagnosis and gather demographic and disease-related data. Population-adjusted annual incidence rates for IBD surgery were calculated by dividing the number of surgeries by estimates for total population of CD patients in Edmonton. Time-trend analysis was conducted to identify change points, calculate annual percent change (APC), and associated 95% confidence intervals (CIs). Results A total of 1410 patients with Crohn’s disease underwent surgery for their disease. The surgical rate decreased by 8.4% each year (95% CI, −9.6% to −7.3%). There was a 36.2% increase in the use of anti-TNF therapy per year (95% CI, 31.3% to 41.5%). Changes in modifiable risk factors for surgery were also seen, including the proportion of active smokers decreasing by 2.2% per year (95% CI, −3.7% to −0.6%). Conclusions Although anti-TNF therapy seems to play a role, the decrease in surgical trends is likely multifactorial, owing to a decline in smoking trends, earlier diagnosis, earlier treatment, improved patient education, and changes in clinical practice.

76 Surgical Resection Rates for Crohn's Disease Are Decreasing: A Population-Based Time Trend Analysis

2016 ◽  
Vol 150 (4) ◽  
pp. S20
Author(s):  
Christopher Ma ◽  
Remo Panaccione ◽  
Gordon W. Moran ◽  
Eric Benchimol ◽  
Steven Heitman ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Trend Analysis ◽  
Surgical Resection ◽  
Time Trend ◽  
Population Based

scholarly journals Reduction in surgical stoma rates in Crohn's disease: a population‐based time trend analysis

2019 ◽  
Vol 21 (11) ◽  
pp. 1279-1287 ◽  
Author(s):  
C. Ma ◽  
A. Almutairdi ◽  
D. Tanyingoh ◽  
C. H. Seow ◽  
K. L. Novak ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Trend Analysis ◽  
Time Trend ◽  
Population Based

scholarly journals Surgical Rates for Crohn’s Disease are Decreasing: A Population-Based Time Trend Analysis and Validation Study

2017 ◽  
Vol 112 (12) ◽  
pp. 1840-1848 ◽  
Author(s):  
Christopher Ma ◽  
Gordon W Moran ◽  
Eric I Benchimol ◽  
Laura E Targownik ◽  
Steven J Heitman ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Trend Analysis ◽  
Validation Study ◽  
Time Trend ◽  
Population Based

scholarly journals DOP039 Exploring stoma rates in Crohn’s disease in the biologic era: a population-based time trend analysis

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S057-S058
Author(s):  
C Ma ◽  
P G Kotze ◽  
A Almutairdi ◽  
D Tanyngoh ◽  
C Seow ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Trend Analysis ◽  
Time Trend ◽  
Population Based

474 - Exploring Stoma Rates in Crohn's Disease in the Biologic Era: A Population-Based Time Trend Analysis

2018 ◽  
Vol 154 (6) ◽  
pp. S-111-S-112
Author(s):  
Abdulelah A. Almutairdi ◽  
Christopher Ma ◽  
Paulo G. Kotze ◽  
Divine Tanyingoh ◽  
Cynthia H. Seow ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Trend Analysis ◽  
Time Trend ◽  
Population Based

The Incidence of Deep Venous Thrombosis and Pulmonary Embolism among Patients with Inflammatory Bowel Disease: A Population-based Cohort Study

2001 ◽  
Vol 85 (03) ◽  
pp. 430-434 ◽  
Author(s):  
James Blanchard ◽  
Donald Houston ◽  
Andre Wajda ◽  
Charles Bernstein
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Pulmonary Embolism ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Population Based ◽  
Incidence Rates ◽  
Increased Risk ◽  
Inflammatory Bowel

Summary Background: There is an impression mostly from specialty clinics that patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolic disorders. Our aim was to determine the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) from a population-based database of IBD patients and, to compare the incidence rates to that of an age, gender and geographically matched population control group. Methods: IBD patients identified from the administrative claims data of the universal provincial insurance plan of Manitoba were matched 1:10 to randomly selected members of the general population without IBD by year, age, gender, and postal area of residence using Manitoba Health’s population registry. The incidence of hospitalization for DVT and PE was calculated from hospital discharge abstracts using ICD-9-CM codes 451.1, 453.x for DVT and 415.1x for PE. Rates were calculated based on person-years of follow-up for 1984-1997. Comparisons to the population cohort yielded age-adjusted incidence rate ratios (IRR). Rates were calculated based on person-years of follow-up (Crohn’s disease = 21,340, ulcerative colitis = 19,665) for 1984-1997. Results: In Crohn’s disease the incidence rate of DVT was 31.4/10,000 person-years and of PE was 10.3/10,000 person-years. In ulcerative colitis the incidence rates were 30.0/10,000 person-years for DVT and 19.8/10,000 person-years for PE. The IRR was 4.7 (95% CI, 3.5-6.3) for DVT and 2.9 (1.8-4.7) for PE in Crohn’s disease and 2.8 (2.1-3.7) for DVT and 3.6 (2.5-5.2) for PE, in ulcerative colitis. There were no gender differences for IRR. The highest rates of DVT and PE were seen among patients over 60 years old; however the highest IRR for these events were among patients less than 40 years. Conclusion: IBD patients have a threefold increased risk of developing DVT or PE.

scholarly journals DOP72 Perianal Crohn’s Disease in the biologic era: A population-based cohort study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S105-S107
Author(s):  
P Jenkinson ◽  
N Plevris ◽  
M Lyons ◽  
S Siakavellas ◽  
I Arnott ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Cumulative Incidence ◽  
Population Based ◽  
Incidence Rates ◽  
Percentage Change ◽  
Prescription Data ◽  
Annual Percentage Change ◽  
Kaplan Meier ◽  
Significant Difference

Abstract Background Peri-anal Crohn’s disease (pCD) significantly affects quality of life in patients with CD. The natural history of pCD in the era of biologic therapy is poorly understood. Perianal surgery includes examination under anaesthesia (EUA), drainage of peri-anal sepsis, seton instertion and fistula manipulation. EUA forms part of the standard of care at diagnosis of pCD and therefore can be used as a proxy for incidence of pCD. Methods CD patients were identified from the Lothian IBD registry, a physician validated registry of all IBD cases within Lothian which has been shown to be 94.3% complete. Prospectively collected coding data was used to identify peri-anal surgery, which was validated by review of the electronic health record. Biologic prescription data was extracted from the Lothian biologics database; a physician validated, prospectively collected registry. Time trend analysis was performed for the period 2000 to 2017 by 1) calculating annual incidence rates of peri-anal interventions for all patients with CD and estimating annual percentage change and 2) by calculating cumulative incidence of pCD and biologic prescription in newly diagnosed CD and 3) stratifying by era of diagnosis (Cohort 1: 2000–2008 and Cohort 2: 2009–2017. Results 2937 patients with CD were identified in the study period, with 1108 operations for pCD performed on 381 patients. Rates of surgery fell from 5.1 to 2.0 operations per 100 CD patients per year between 2000 and 2017 (p<0.001) giving an annual percentage change of -3.4% (-4.9% to -1.9% 95% CI) (fig 1). 1753 new diagnoses of CD were made of whom 247 developed pCD. 5 year risk of pCD was 12.8% (9.5–16.6%) with no significant difference identified between cohort 1 (11.5%) and cohort 2 (13.8%) (p=0.116) (fig 2). The 5 year incidence of biologic prescription for patients with pCD increased from 11.2% in cohort 1 to 58.1% in cohort 2 (p<0.001) (fig 3). Figure 1: Number of peri-anal interventions per 100 CD patients per year (multiple procedures per patient included). Figure 2: Kaplan Meier curves showing cumulative incidence of pCD stratified by era of diagnosis. Figure 3: Kaplan Meier curves showing cumulative incidence of biologic prescription in patients with CD stratified by era of diagnosis and presence of pCD. Conclusion The incidence of pCD remains unchanged over time. Although we cannot ascribe causality, the overall decrease in surgery for pCD has been paralleled by a marked increase in the use of biologic medication.

scholarly journals A28 RELATIVE RATES OF ULCERATIVE COLITIS TO CROHN’S DISEASE: PARALLEL EPIDEMIOLOGIES IN NEWLY VS. HIGHLY INDUSTRIALIZED COUNTRIES

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 34-35 ◽  
Author(s):  
J W Windsor ◽  
M Buie ◽  
S Coward ◽  
R Gearry ◽  
T Hansen ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Prevalence Ratio ◽  
Population Level ◽  
Industrialized Countries ◽  
Annual Percent Change ◽  
Newly Industrialized Countries ◽  
Log Linear ◽  
Over Time

Abstract Background Inflammatory bowel disease (IBD) first presents in a population as cases of ulcerative colitis (UC) followed by cases of Crohn’s disease (CD). Newly industrialized countries (NIC) show a prallel epidemiology of IBD to highly industrialized countries (HIC) in the previous century; one marker of this is the relative incidence/prevalence rates of UC to CD, which approximates 1 over time. Aims Provide evidence for the UC:CD ratio as a proxy for disease penatrance in a population. Methods Systematic review of MedLine and Embase for studies reporting incidence or prevalence of UC and CD. Log-linear regression (by region and NIC/HIC [2019 United Nations definitions]) was used to calculate average annual percent change (AAPC) and associated 95% confidence intervals (CI). Data were plotted on an online, interactive map to show trends (link provided). Results We extracted data from 218 studies compising population-level data from 69 countries. We found negative AAPCs as the prevalence ratio of UC:CD significantly decreased over time in East Asia, West Asia, North Europe, and South Europe; 6/12 global regions displayed significantly decreasing incidence ratios. No AAPC was found to be significantly increasing (Table 1). When examing HIC/NIC, we found a significant effect of NIC on the UC:CD prevalence ratio after 2000 (AAPC:−3.83;95%CI:−6.28,−1.31) while HIC regions remained stable (AAPC:2.14;95%CI:−1.40,5.82). Looking at all available data, both HICs and NICs show significantly decreasing UC:CD prevalence ratios (HIC:AAPC:−3.72;95% CI:−4.46,−2.97; NIC:AAPC:−2.62;95%CI:−4.13,−1.08). Conclusions In some HICs (eg. Canada), the UC:CD incidence ratio was <1 in the earliest available data (1966), explaining the stable AAPC in North America (AAPC:−0.24;95%CI:−1.12,0.65). However, in NICs (eg. Southern Asia), the AAPC is rapidly decreasing (AAPC:−24.68;95%CI:−37.85,−8.71) as areas like Sri Lanka rapidly fall from an incidence ratio of 7.5 (2007) to 2.8 (2012), mimicking trends in IBD epidimeology of HICs in the previous century. Funding Agencies None

Tu1306 Surgical Rates Have Decreased for Emergent Crohn's Disease Resections While Increasing for Elective Resections: A Population-Based Time Trend Study

2012 ◽  
Vol 142 (5) ◽  
pp. S-798 ◽  
Author(s):  
Gilaad G. Kaplan ◽  
Gordon W. Moran ◽  
Alexandra Frolkis ◽  
Kevin P. Rioux ◽  
Subrata Ghosh ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Time Trend ◽  
Population Based ◽  
Trend Study
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