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Surgical Treatment in Childhood-onset Inflammatory Bowel Disease: A Nationwide Register-based Study of 4695 Incident Patients in Sweden 2002-2014
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Karolinska Inst, Sweden.
Karolinska Inst, Sweden.
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no 2, p. 157-166Article in journal (Refereed) Published
Abstract [en]

Background and Aims

The incidence of childhood-onset [< 18 years] inflammatory bowel disease [IBD] is increasing worldwide, and some studies suggest that it represents a more severe disease phenotype. Few nationwide, population-based studies have evaluated the surgical burden in patients with childhood-onset IBD, and whether the improved medical treatment has influenced the need for gastrointestinal surgery. The aim was to examine whether the surgical treatment at any age of patients with childhood-onset IBD has changed over time.

Methods

In a nationwide cohort study we identified 4695 children [< 18 years] diagnosed with incident IBD in 2002–2014 through the Swedish Patient Register [ulcerative colitis: n = 2295; Crohn’s disease: n = 2174; inflammatory bowel disease-unclassified: n = 226]. Abdominal [intestinal resections and colectomies] and perianal surgeries were identified through the Swedish Patient Register. The cumulative incidences of surgeries were calculated using the Kaplan-Meier method.

Results

In the cohort, 44% were females and 56% males. The median age at inflammatory bowel disease diagnosis was 15 years and the maximum age at end of follow-up was 31 years. The 3-year cumulative incidence of intestinal surgery was 5% in patients with ulcerative colitis and 7% in patients with Crohn’s disease, and lower in children aged < 6 years at inflammatory bowel disease diagnosis [3%] than in those aged 15–17 years at diagnosis [7%]. Calendar period of inflammatory bowel disease diagnosis was not associated with risk of surgery.

Conclusion

Over the past 13 years, the risk of surgery in childhood-onset inflammatory bowel disease has remained unchanged.

Place, publisher, year, edition, pages
Oxford University Press, 2018. Vol. 12, no 2, p. 157-166
Keywords [en]
Children; inflammatory bowel disease; surgery
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-145116DOI: 10.1093/ecco-jcc/jjx132ISI: 000423703000004PubMedID: 29029152Scopus ID: 2-s2.0-85041295862OAI: oai:DiVA.org:liu-145116DiVA, id: diva2:1183682
Note

Funding Agencies|Bengt Ihre research fellowship; Swedish Medical Society; Karolinska Institutet Foundations; Stockholm County Council; Jane and Dan Olsson Foundation; Kempe Carlgrenska Foundation; Mjolkdroppen Foundation; Swedish Research Council; Stockholm County Council [ALF project]

Available from: 2018-02-19 Created: 2018-02-19 Last updated: 2018-02-27Bibliographically approved

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Rosvall, OdaMyrelid, Pär
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Department of Clinical and Experimental MedicineFaculty of Medicine and Health SciencesDepartment of Surgery in LinköpingDivision of Surgery, Orthopedics and Oncology
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