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P701 Late-onset Crohn's disease is associated with high risk of intestinal perforation and low risk of perianal fistula as compared with early-onset Crohn's disease: the CONNECT cohort

Kim H.M.*1, Kim H.-S.1, Kim J.S.2, Kim Y.S.3, Cheon J.H.4, Ye B.D.5, Kim Y.H.6, Han D.S.7

1Yonsei University Wonju College of Medicine, Division of Gastroenterology and Hepatology, Wonju, South Korea 2Seoul National Uinversity College of Medicine, Internal Medicine and Liver Research Institute, Seoul, South Korea 3Inje University College of Medicine, Internal Medicine, Seoul, South Korea 4Yonsei University College of Medicine, Internal Medicine and Institute of Gastroenterology, Seoul, South Korea 5University of Ulsan College of Medicine, Asan Medical Center, Gastroenterology and Inflammatory Bowel Disease Center, Seoul, South Korea 6Sungkyunkwan University School of Medicine, Department of Internal Medicine, Seoul, South Korea 7Hanyang University Guri Hospital, Department of Internal Medicine, Guri, South Korea

Background

The late-onset Crohn's disease has several different clinical characteristics from the early-onset Crohn's disease. This study was aimed to compare abdominal and perianal complications between early-onset and late-onset Crohn's disease.

Methods

The Crohn's Disease Clinical Network and Cohort (CONNECT) retrospective cohort was used in this study. Between 1982 and 2010, patients with confirmed Crohn's disease were enrolled. The early-onset Crohn's disease was defined as age at the diagnosis ≥20 and 30< (549 patients), and the late-onset as ≥40 and <70 (185 patients). The multivariable logistic regression analyses were performed with adjustment of sex, smoking, location (L), and behavior (B) or Crohn's disease.

Results

The patients with late-onset Crohn's disease underwent higher rate of abdominal surgery and lower rate of perianal surgery than those with the early-onset Crohn's disease (33.0% vs. 25.0% and 3.8% vs. 22.6%, p<0.0001). The patients with late-onset Crohn's disease had lower rate of perianal fistula than those with the early-onset Crohn's disease (14.8% vs. 41.7%, p<0.0001). In the multivariable analysis, the patients with late-onset Crohn's disease had odds ratio of 3.090 (n=312, 95% confidence interval [CI]: 1.228–7.772, p=0.017) for intestinal perforation, and odds ratio of 0.122 (n=313, 95% CI: 0.053–0.285, p<0.0001) for perianal fistula.

Table 1. Association between late-onset Crohn's disease and complications

Dependent variableNumberOdds ratio (95% CI)*p value
Intestinal perforation3123.090 (1.228–7.772)0.017
Intrabdominal abscess3130.703 (0.261–1.890)0.485
Intestinal stricture3110.956 (0.464–1.968)0.903
Perianal fistula3130.122 (0.053–0.285)$<0.0001$

Conclusion

The late-onset Crohn's disease is associated with high risk of abdominal surgery and intestinal perforation, but low risk of perianal fistula as compared with the early-onset Crohn's disease.

This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention. (2013-E63004–01)