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The risk of developing Crohn's disease after an appendectomy: A meta-analysis
Inflammatory Bowel Disease Clinic, University of Calgary, Calgary, AB, Canada, Departments of Medicine and Community Health Sciences, Teaching Research and Wellness Center, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4N1, Canada.
Department of Surgery, McMaster University, Hamilton, ON, Canada.
Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Department of Epidemiology Research, Division of Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
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2008 (English)In: American Journal of Gastroenterology, ISSN 0002-9270, E-ISSN 1572-0241, Vol. 103, no 11, 2925-2931 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Studies exploring the association between appendectomy and Crohn's disease (CD) have reported conflicting findings. We conducted a systematic review of the literature and a meta-analysis to assess the risk of CD following an appendectomy and determine the effect of time between appendectomy and CD diagnosis. METHODS: MEDLINE was used to identify observational studies evaluating the association between appendectomy and CD. Authors were contacted when data were insufficient. Relative risks (RR) with 95% confidence intervals (CI) were calculated using a random effects model. Studies that analyzed their data by the interval between the appendectomy and the diagnosis of CD were assessed separately. The Woolf ?2 statistic was used to test for homogeneity. Egger's test was used to evaluate publication bias. RESULTS: The summary RR estimate for CD following an appendectomy was significantly elevated (RR 1.61, 95% CI 1.28-2.02), though heterogeneity was observed (P < 0.0001). The risk was elevated within the first year following the operation (RR 6.69, 95% CI 5.42-8.25). The risk of CD was also significantly increased 1-4 yr following an appendectomy (RR 1.99, 95% CI 1.66- 2.38), however, after 5 yr or more, the risk fell to baseline levels (RR 1.08, 95% CI 0.99-1.18). Publication bias was not detected (P = 0.2). CONCLUSION: The meta-analysis demonstrated a significant risk of CD following an appendectomy, though heterogeneity was observed between the studies. The elevated risk early after an appendectomy, which diminishes thereafter, likely reflects diagnostic problems in patients with incipient CD. © 2008 by Am. Coll. of Gastroenterology.

Place, publisher, year, edition, pages
2008. Vol. 103, no 11, 2925-2931 p.
National Category
Natural Sciences
URN: urn:nbn:se:liu:diva-48432DOI: 10.1111/j.1572-0241.2008.02118.xOAI: diva2:269328
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2010-05-24

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Andersson, Rolland E
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