In Crohn's disease, studies associating phenotype at diagnosis and disease activity are important for patient counselling and health care planning.
Dr Wolters and colleagues from the Netherlands calculated disease recurrence rates and correlated these with phenotypic traits at diagnosis.
The research team prospectively assembled a European population based inception cohort of Crohn's patients.
The patients were classified according to the Vienna classification for disease phenotype at diagnosis.
The researchers calculated surgical and non-surgical recurrence rates throughout a 10 year follow up period.
|73% had a first recurrence during the first 10 years after diagnosis|
Multivariate analysis was performed to classify risk factors present at diagnosis for recurrent disease.
The team classified a total of 358 for phenotype at diagnosis.
Of those classified, 73% had a first recurrence and 32% a first surgical recurrence during the first 10 years after diagnosis.
The researchers found that patients with upper gastrointestinal disease at diagnosis had an excess risk of recurrence.
The team noted that age 40 years at diagnosis was protective.
Colonic disease was a protective characteristic for resective surgery.
The team observed that more frequent resective surgical recurrences were reported from Copenhagen.
Dr Wolter's team concludes, “A mild course of disease in terms of disease recurrence was observed in this European cohort.”
“Phenotype at diagnosis had predictive value for disease recurrence with upper gastrointestinal disease being the most important positive predictor.”
“A phenotypic North-South gradient in Crohn's disase may be present, illustrated by higher surgery risks in some of the Northern European centers.”