P319. The prevalence and clinical characteristics of refractory Crohn's disease in South China
Y. He, P. Xu, Z. Zeng, B. Chen, R. Mao, K. Chao, M. Chen, The First Affiliated Hospital of SunYat-Sen University, Gastroenterology, Guangzhou, China
To analyze the clinical characteristics of refractory Crohn's disease (CD) which was steroid-dependent, thiopurines ineffective in South China.
All clinical data were collected from 425 consecutive CD patients from the First Affiliated Hospital of SunYat-Sen University between January 2003 and June 2013. Clinical features, therapeutic approaches and effects were analyzed. A multivariate logistic regression was performed to identify risk factors of refractory CD.
(1) The rates of steroid-dependent and ineffective to thiopurines were 27.5% (117/425) and 21.9% (93/425) respectively. (2) Univariate analysis showed that perianal disease (P = 0.035), abdominal pain (P = 0.027), diarrhea (P = 0.011), bloody stool (P = 0.003), fever (P = 0.000), higher white blood cell (P = 0.031), lower haemoglobin (Hb) (P = 0.002), lower hematokrit (P = 0.028) and lower albumin level (P = 0.007) were risk factors for steroid-dependant CD patients. Multivariate logistic regression showed that only fever (OR = 3.646, 95% CI: 1.849–7.191, P = 0.000) and low Hb (OR = 1.016, 95% CI: 1.001–1.031, P = 0.004) were independent risk factors related to steroid-dependent. (3) Univariate analysis showed that perianal disease (P = 0.033), abdominal pain (P = 0.009), diarrhea (P = 0.046), fever (P = 0.011), lower haemoglobin (P = 0.003), high erythrocyte sedimentation rate (ESR) (P = 0.032) and higher hypersensitivity C-reactive protein (HsCRP) (P = 0.006) are risk factors of ineffective or intolerant to thiopurines CD patients. Multivariate logistic regression showed that only abdominal pain (OR = 4.875, 95% CI: 1.389–17.116, P = 0.013) and higher HsCRP (OR = 0.976, 95% CI: 0.952–1.000, P = 0.049) were independent risk factors related to ineffective or intolerate to thiopurines.
Around one quarter of CD patients in South China became refractory during the course of disease. Fever and low Hb were independent risk factors for CD patients developed steroid-dependant. Abdominal pain and high HsCRP were independent risk factors related to ineffective to thiopurines.