Smoking influences the need for surgery in patients with the inflammatory bowel diseases: a systematic review and meta-analysis incorporating disease duration. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Kuenzig, M.; Lee, Sang; Eksteen, Bertus; Seow, Cynthia; Barnabe, Cheryl; Panaccione, Remo; Kaplan, Gilaad
• Is Part Of: BMC gastroenterology. Volume 16:Issue 1(2016)
• Page Start: 1
• Page End: 9
• Publication Date: 2016-12
• Subjects: Crohn's disease -- Ulcerative colitis -- Inflammatory bowel disease -- Cigarette smoking -- Intestinal resection -- Colectomy -- Survival analysis -- Meta-analysis; Gastroenterology -- Periodicals; Gastrointestinal Diseases -- Periodicals; Biliary Tract Diseases -- Periodicals; Molecular Biology -- Periodicals; Liver Diseases -- Periodicals; 616.33005
• DOI: 10.1186/s12876-016-0555-8
• Languages: English
• ISSNs: 1471-230X

Abstract

Abstract Background Studies examining the association between smoking and the need for surgery in patients with Crohn's disease and ulcerative colitis have reached inconsistent conclusions. These studies often do not differentiate between patients undergoing early surgery and patients having surgery later in their disease course. Our study examined the association between smoking status and time to first bowel resection in patients with Crohn's disease and ulcerative colitis. Methods We searched MEDLINE and EMBASE for studies (n = 12) reporting on the association between smoking status (current, former, and never) and surgery in IBD, and incorporated disease duration in the analysis. Hazard ratios (HR) with 95% confidence intervals (CI) were pooled across studies using random effects models. Results Current smokers with Crohn's disease were at increased risk of intestinal resection compared to never smokers (HR 1.27, 95% CI 1.08 to 1.49); however, there was no difference in the need for surgery when comparing former and never smokers (HR 1.11, 95% CI 0.95 to 1.30). In patients with ulcerative colitis, there was no difference in the need for colectomy when comparing current smokers to never smokers (HR 0.98, 95% CI 0.67 to 1.44). Former smokers with ulcerative colitis were at increased risk of colectomy (HR 1.38, 95% CI 1.04 to 1.83) compared to never smokers. Conclusions Current smokers with Crohn's disease are at increased risk of surgery, while former smokers with ulcerative colitis have increased risk of colectomy.