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P659. Clinical features of Crohn's disease at diagnosis: a Korean multicenter nationwide cohort study

B.D. Ye1, J.W. Kim2, D.S. Han3, E.J. Youn1, J.H. Lee4, H.-S. Kim5, S.J. Park6, H.-S. Kim7, Y.S. Kim8, Y.-H. Kim9, C.H. Choi10, K.-M. Lee11, C.K. Lee12, S.-K. Yang1, H.J. Kim12, W.H. Kim6, 1Asan Medical Center, Gastroenterology, Inflammatory Bowel Disease Center, Seoul, South Korea, 2Seoul National University Borame Hospital, Internal Medicine, Seoul, South Korea, 3Hanyang University Guri Hospital, Internal Medicine, Guri, South Korea, 4Seoul Song Do Colorectal Hospital, Digestive Endoscopic Center, Seoul, South Korea, 5Chonnam National University Medical School, Internal Medicine, Gwangju, South Korea, 6Yonsei University College of Medicine, Internal Medicine, Institute of Gastroenterology, Seoul, South Korea, 7Yonsei University Wonju College of Medicine, Internal Medicine, Wonju, South Korea, 8Seoul Paik Hospital, Inje University, College of Medicine, Internal Medicine, Seoul, South Korea, 9Samsung Medical Center, Sungkyunkwan University School of Medicine, Medicine, Seoul, South Korea, 10Chung-Ang University College of Medicine, Internal Medicine, Seoul, South Korea, 11St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Internal Medicine, Suwon, South Korea, 12Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Internal Medicine, Seoul, South Korea

Background

Although the incidence and prevalence of Crohn's disease (CD) are considered to be steadily increasing in Asian countries including Korea, the clinical features and long-term prognosis of Asian CD patients are still unclear. Therefore, a novel nationwide hospital-based cohort of patients with CD was designed to reveal the disease characteristics and outcomes.

Methods

The executive committee consisted of nine specialists on inflammatory bowel disease was organized to launch the novel Korean CD patient cohort study. The general goals of the Korean CD cohort study were established as follows; To provide a disease-oriented, hospital-based cohort of CD patients, thereby to investigate the epidemiologic and clinical features of CD at diagnosis, to elucidate the outcomes and prognostic factors, and to reveal the genetic, immunologic, and microbiologic factors related with risk and prognosis of CD by analyzing biosamples. With these goals, patients with definitive CD were enrolled and their data were collected through a web-based system using a secure internet server. Preliminary analyses of patients' characteristics at diagnosis of CD were performed. The study protocol is registered at www.clinicaltrials.gov (NCT01554007).

Results

Patients diagnosed with CD after 1 January 2009 were decided to be eligible for enrollment. A total of 288 patients enrolled from 22 hospitals were analyzed to reveal the characteristics of patients at diagnosis. The male-to-female ratio was 2.7:1 and the median age at diagnosis was 21 years (range, 11–66 years). Twenty-five (8.7%) and sixteen (5.6%) were previously misdiagnosed with intestinal tuberculosis and ulcerative colitis, respectively. One hundred and five patients (36.5%) had a history of perianal fistulae. The Montreal location at diagnosis was as follows; ileal disease in 71 (24.7%), colonic disease in 28 (9.7%), and ileocolonic disease in 189 (65.6%). The Montreal behavior at diagnosis was as follows; Non-stricturing and non-penetrating in 207 (71.9%), stricturing in 28 (9.7%), and penetrating in 53 (18.4%).

Conclusion

Through the systematic approach and collaboration of investigators from multiple centers, we could set up a new hospital-based cohort of CD in Korea. Korean patients with CD appear to show male-predominance, high frequency of perianal fistulae, and low proportion of isolated colonic disease. Further enrollment and a long-term meticulous follow-up of patients from multiple qualified centers throughout the nation are needed.