Abstract
Background
The aim of this study was to clarify the risk and characteristics of intestinal failure (IF) in patients with Crohn’s disease (CD).
Methods
The present study was a retrospective study in 12 hospitals. CD patients who underwent initial surgery at any of the 12 hospitals between 1970 and 2009 were collected (n = 1,703). Those who developed IF were reviewed (n = 68), and the cumulative risk of IF was analyzed by the Kaplan–Meier method. In addition, IF patients who underwent initial surgery at other hospitals and were then treated at any of the 12 hospitals were also reviewed (n = 33). Thus, a total of 101 IF patients were collected, and the cumulative risk of IF-related death was analyzed.
Results
The cumulative risk of IF after the initial surgery was 0.8 % (5 years), 3.6 % (10 years), 6.1 % (15 years), and 8.5 % (20 years). In CD patients with IF, mean age at initial surgery, IF occurrence, and present age at the time of the study were 28.2, 38.2, and 46.1 years, respectively. The mean number of surgeries per patient was 3.3. The mean length of the remnant small bowel was 163 cm. Twelve IF patients (12 %) had died and the cumulative risk of IF-related death by the time from the occurrence of IF was 1.1 % (3 years), 3.7 % (5 years), 6.5 % (7 years), and 8.9 % (10 years).
Conclusion
The occurrence of IF and IF-related death in CD patients is not rare over the long term. There is a pressing need to develop strategies for the prevention and management of IF.
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Acknowledgments
The authors thank Hitoshi Ogawa and Sho Haneda (Tohoku University Hospital), Ken-ichi Takahashi (Tohoku Rosai Hospital), Daijiro Higashi (Fukuoka University Chikushi Hospital), Michio Itabashi and Shinpei Ogawa (Tokyo Women’s Medical University), Toshimitsu Araki (Mie University Hospital), Keiji Matsuda (Teikyo University Hospital), Shinji Nakamura (Nara Medical University Hospital), Katsuyoshi Hatakeyama and Tsuneo Iiai (Nigata University Hospital), and Masahiko Watanabe (Kitasato University Hospital) for collecting data and/or important intellectual contributions.
Conflict of interest
This work was supported in part by Health and Labour Sciences Research Grants for research on intractable diseases from the Ministry of Health, Labour and Welfare of Japan.
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The present study was performed as a project study under the Surgical Research Group, the Research Committee of Inflammatory Bowel Disease, Ministry of Health, Labour and Welfare of Japan.
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Watanabe, K., Sasaki, I., Fukushima, K. et al. Long-term incidence and characteristics of intestinal failure in Crohn’s disease: a multicenter study. J Gastroenterol 49, 231–238 (2014). https://doi.org/10.1007/s00535-013-0797-y
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DOI: https://doi.org/10.1007/s00535-013-0797-y