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P630. Epidemiological and phenotypic characteristics of IBD patients in Romania - results of a nationwide hospital-based registry

Background

Epidemiology of IBD is changing in Eastern Europe as well as in other parts of the Globe as population is adopting a life style similar to western countries. In Romania diagnosis and therapeutic management of patients with IBD is conducted mainly in referral centers.

Aim: We have therefore implemented a web-accessed database to facilitate collection of significant IBD epidemiological data Nationwide in our country (IBDPROSPECT).

Methods

During the study period (2006–2013) significant epidemiological and phenotypical variables were registered from 1217 IBD Romanian patients from 13 referral centers. Statistical analysis was conducted using chi-square test for categorical variables, time data was analysed by log-rank test. P value <0.05 was considered for statistical significance.

Results

Complete phenotypic data for analysis was available from 1009 patients. Phenotypic distribution was: ulcerative colitis (UC) 57.3%, Crohn's disease (CD) 38.9%, and inflammatory bowel disease unclassified (IBD-U) 2.9% with a highly significant geographic difference - higher incidence of CD in the south-west of vs. higher incidence of UC in the north-east of our country (p < 0.00001). CD was more frequently encountered in younger patients and in females whereas UC was more prevalent in patients over 40 years (57.6%) and in males (55.5%). First degree relatives with IBD were encountered in 3.3% of cases (3.7% in CD vs 2.9% in UC). 71.5% of patients were residing in urban areas. Location of CD according to Montreal classification was: 14.9% L1, 41.8% L2, 39.3% L3 (4% not specified). 4% of patients were classified as L4 with a strong association of L4 location with L1 (37.9% p = 0.009). Perianal disease was present in 14% of cases and was associated with L3 location (54.3%, p = 0.02). B1 behaviour at time of inclusion in the registry was registered in 48.8% of patients, B2 in 23.1% and B3 in 12.1% of patients (16% not specified). In patients with UC, E1 extension was encountered in 18.5% of patients, E2 in 50.9% E3 28.4% (2.2% not specified). Mean diagnostic delay was 17.3 months in CD vs. 5.3 months in UC (p < 0.00001).

Conclusion

Our study has emphasized several epidemiological and phenotypical features of IBD patients characteristic for Romania: higher UC incidence, south-west to north-east phenotypic gradient, low familial aggregation of cases, colonic involvement of IBD. Phenotypic features might change in the years to come so a thorough investigation of epidemiological factors by a population based cohort is mandatory.

  • Written by:

    C. Gheorghe1, A. Dimitriu1, R. Iacob1, M. Cojocaru1, C. Lupei1, R. Vadan1, D. Dobru2, A. Trifan3, M. Tantau4, A. Goldis5, G. Constantinescu6, S. Gologan7, B. Mateescu8, D. Gheonea9, L. Gheorghe1, M. Diculescu1, on behalf of the IBDPROSPECT Study Group, 1Fundeni Clinical Institute, Digestive Diseases and Liver Transplantation Center, Bucharest, Romania, 2Municipal Hospital Targu Mures, Gastroenterology, Targu Mures, Romania, 3Gastroenterology and Hepatology Institute Iasi, Gastroenterology, Iasi, Romania, 43rd Medical Clinic Cluj-Napoca, Gastroenterology, Cluj-Napoca, Romania, 5District Hospital Timisoara, Gastroenterology, Timisoara, Romania, 6Floreasca Emergency Hospital, Gastroenterology, Bucharest, Romania, 7Elias Universitary Hospital, Gastroenterology, Bucharest, Romania, 8Colentina Clinical Hospital, Gastroenterology, Bucharest, Romania, 9University of Medicine and Pharmacy Craiova, Romania, Immunology, Craiova, Romania