Baseline clinical factors tied to complications risk in Crohn's disease

The number of risk factors compiled by the American Gastroenterological Association (AGA) is significantly associated with the risk of disease complications in Crohn’s disease (CD), but not in ulcerative colitis (UC), reports a study. The presence of three or more risk factors in CD contributes to the highest risk of complications.

Participants from two cohorts (the Ocean State Crohn’s and Colitis Area Registry cohort [OSCCAR] and the Mayo Clinic [MC] cohort) were included in this study. The authors extracted baseline clinical risk factors according to the AGA pathway.

An analysis was also performed on the association between the number of AGA risk factors and the primary endpoint, defined as any inflammatory bowel disease (IBD)-related hospitalization, any IBD-related bowel surgery, or any progression of disease. Cox proportional hazards model was used to perform statistical multivariable modelling.

In total, 412 CD patients were included in the analysis. Three or more risk factors, compared with 0‒1, led to a significant increase in complications risk in both the OSCCAR (hazard ratio [HR], 2.75, 95 percent confidence interval [CI], 1.71‒4.41) and MC cohorts (HR, 2.07, 95 percent CI, 1.11‒3.84).

Likewise, diagnosis at a younger age (HR, 2.07), perianal disease (HR, 1.99), and B2/B3 behaviour (HR, 1.92) significantly correlated with disease complications.

In the 265 patients with UC, no consistent association was observed between the number of risk factors or any specific individual risk factors and the risk of disease complications.

“The AGA care pathway is a useful tool to stratify patients who are at higher risk of disease complications in patients with CD,” the authors said.