Risk factors associated with surgery and postoperative recurrence in patients with Crohn's disease

Objective To explore the risk factors associated with surgery and postoperative recurrence in patients with Crohn's disease (CD). Methods A total of 183 patients diagnosed as CD from January 2008 to December 2013 were enrolled. Forty-six patients after surgery were assigned to surgery group, and 137 non-surgical CD patients were assigned to control group. All the patients were followed up until the endpoint of the study or death, and the follow-up period was at least 12 months. Typing was according to the Montreal classification.The risk factors associated with surgery and postoperative recurrence were analyzed by Logistic regression. Results The surgery rate of CD patients was 25.1%(46/183), the postoperative clinical recurrence rate of surgery group was 39.1% (18/46), and the recurrence time was 20 months (7~42 months). Before surgery, the rate of definite diagnosis of CD was only 13.0% (6/46). Stricture (odd ratio (OR)=5.836, 95% confidence interval (CI) 2.199 to 15.487, P<0.01) and penetration (OR=25.706, 95%CI 7.091 to 93.190, P<0.01) were independent risk factors for the surgery. Furthermore, perianal disease(OR=23.550, 95%CI 1.311 to 422.912, P=0.032) and lack of prophylaxes treatment after surgery (OR=58.701, 95%CI 1.803 to 1 991.000, P=0.022) were independent risk factors for postoperative clinical recurrence. Conclusions Stricture and penetration are risk factors for surgery.Perianal disease and lack of prophylaxes treatment after surgery are risk factors for postoperative clinical recurrence. Key words: Crohn's disease; Colorectal surgery; Postoperative recurrence; Risk factors