Clinical characteristics and long-term prognosis of elderly-onset Crohn's disease. (3rd April 2018)

• Record Type: Journal Article
• Authors: Song, Eun Mi; Kim, Nayoung; Lee, Sun-Ho; Chang, Kiju; Hwang, Sung Wook; Park, Sang Hyoung; Yang, Dong-Hoon; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun; Ye, Byong Duk
• Is Part Of: Scandinavian journal of gastroenterology. Volume 53:Number 4(2018)
• Page Start: 417
• Page End: 425
• Publication Date: 2018-04-03
• Subjects: Crohn disease -- inflammatory bowel disease -- aged -- geriatrics -- prognosis; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2018.1437927
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Objectives: This study aimed to evaluate the clinical characteristics and clinical course of Asian elderly-onset Crohn's disease (EOCD) patients in a large well-defined cohort of South Korean IBD patients. Materials and methods: From the Asan inflammatory bowel disease registry, we identified 29 EOCD patients (diagnosed with CD in age of 60 years or over) out of 2989 CD patients (1.0%). After excluding two patients with unclear data, 27 EOCD were matched with 108 young-onset CD (YOCD) and 108 middle age-onset CD (MOCD) for the interval from symptom onset to diagnosis (±3 years) and follow-up duration (±3 years). Results: Females were predominant in the EOCD group (59.3%) compared to MOCD (31.5%) and YOCD (29.6%) groups ( p = .012). In EOCD group, terminal ileal location was the most common (63.0%) at diagnosis, whereas ileocolonic location in other groups (57.4% in MOCD and 78.7% in YOCD, respectively) ( p < .001). Patients with perianal fistula at CD diagnosis were less common (14.8% in EOCD vs. 28.7% in MOCD vs. 49.1% in YOCD, p < .001). During follow-up, thiopurines were used less frequently in the EOCD group (48.1% in EOCD vs. 87.0% in MOCD vs. 89.8% in YOCD, p < .001), but the risk for intestinal resection was comparable among three groups ( p = .583). Conclusions: EOCD may have a better clinical course than MOCD and YOCD, as demonstrated by the similar risk for intestinal resection despite the less frequent use of thiopurines.