P149 Clinical Characteristics and Prognosis of Crohn's Disease Patients with Jejunal Involvement in Korea: Results from the CONNECT Study
J.K. Jung*1, D.S. Han1, Y. Ro1, C.S. Eun1, Y.S. Kim2, Y.-H. Kim3, J.H. Cheon4, B.D. Ye5, J.S. Kim6
1Hanyang University Guri Hospital, Gastroenterology, Guri, Korea, Republic of, 2Inje University College of Medicine, Internal Medicine, Seoul, Korea, Republic of, 3Sungkyunkwan University School of Medicine, Internal Medicine, Seoul, Korea, Republic of, 4Yonsei University College of Medicine, Internal Medicine, Seoul, Korea, Republic of, 5University of Ulsan College of Medicine, Internal Medicine, Seoul, Korea, Republic of, 6Seoul National University College of Medicine, Internal Medicine, Seoul, Korea, Republic of
The incidence of Crohn's disease (CD) has been increasing in Korea. Despite disease location is associated with complicated disease phenotype and need for surgery, there are few data of large scaled multicenter study for the prognosis of jejunal involvement in Korean CD patients. We investigated the clinical characteristics and prognosis of CD patients with jejunal involvement in nationwide Korean CD cohort.
This retrospective multicenter cohort study enrolled 1,382 patients diagnosed with CD between 1982 and 2008 from 32 centers in Korea. Clinical characteristics and outcomes of CD patients were evaluated according to jejunal involvement by logistic regression analysis.
Among 1,352 CD patients with complete disease location data, 306 patients (22.6%) had jejunal involvement. Jejunal involvement was significantly associated with ileal location, perianal fistula at diagnosis, and complicated (stricturing and penetrating) behavior. In multivariate analyses, jejunal involvement was independently associated with more common use of steroid at diagnosis and higher operation rates. Remarkably, esophagogastroduodenal (EGD) involvement was more common in patients with jejunal involvement than in those without jejunal involvement (24.8% vs 18.5%, P<0.001).
Jejunal involvement is more common in Korean CD patients compared to western patients. Jejunal disease is a significant risk factor for complicated behavior, common use of steroid at diagnosis, and higher intestinal operation. Upper endoscopy is highly warranted in the evaluation of disease location and prognosis of CD patients.