Identifying patients with Crohn’s disease with rapid disease progress or high risk of early surgery is crucial to clinical decision making.
Dr Wei Liu and colleagues evaluated the correlation between the Lémann index at diagnosis and abdominal surgery in the first year after Crohn’s disease diagnosis and to find the risk factors for early surgery.
The team performed a retrospective cohort study at a single tertiary hospital.
Patients diagnosed with Crohn’s disease between 2013 and 2015 were included.
The researchers' main outcome of interest was the need for an abdominal surgery within 1 year after the Lémann index evaluation at diagnosis.
Of 212 eligible patients, the team noted that 48 patients underwent abdominal surgery during follow-up. Lémann index was much higher in the surgery group.
On tertiles of the Lémann index, the researchers observed that frequency of surgery grew as the Lémann index increased.
|Patients with Lémann index ≥3.7 carried a higher risk of abdominal surgery|
|Diseases of the Colon & Rectum|
The receiver operating characteristic curve was constructed taking into account the Lémann index for selecting patients with a high risk of surgery.
Specificity, sensitivity, and area under receiver operating characteristic curve were 85%, 81%, and 0.89 of the Lémann Index at a cutoff level of 3.7.
The team found that patients with Lémann index ≥3.7 carried a higher risk of abdominal surgery.
The researchers observed that stricturing and penetrating disease were predictors for abdominal surgery, whereas antitumor necrosis factor treatment was associated with a significant reduction of surgical requirements.
Dr Liu's team concluded, "Lémann index at diagnosis is a reliable index to predict the risk of abdominal surgery in the first year after diagnosis of Crohn’s disease."
"Patients with a high Lémann index might need closer follow-up or aggressive medical therapy."