Update on the Natural Course of Fistulizing Perianal Crohn's Disease in a Population-Based Cohort

Sang Hyoung Park, Satimai Aniwan, W. Scott Harmsen, William J. Tremaine, Amy Lightner, William Alvis Faubion, Edward Vincent Loftus, Jr

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND: This study sought to re-estimate the cumulative incidence of perianal or rectovaginal fistulas and the associated proctectomy rate in the prebiologic era vs the biologic era using a population-based cohort of Crohn's disease (CD) patients. METHODS: The medical records of 414 residents of Olmsted County, Minnesota, who were diagnosed with CD between 1970 and 2010 were reviewed. The cumulative incidence of perianal or rectovaginal fistulas from time of CD diagnosis and the cumulative rate of proctectomy from date of first perianal or rectovaginal fistula diagnosis were estimated using the Kaplan-Meier method. RESULTS: Eighty-five patients (20.5%) diagnosed with CD between 1970 and 2010 had at least 1 perianal or rectovaginal fistula episode between January 1, 1970, and June 30, 2016. The cumulative incidence of perianal or rectovaginal fistulas was 18% after 10 years, 23% after 20 years, and 24% after 30-40 years from CD diagnosis. The cumulative incidence of perianal or rectovaginal fistulas was significantly lower in patients diagnosed in 1998 or after than in patients diagnosed before 1998 (P = 0.03, log-rank). Among 85 patients developing perianal or rectovaginal fistulas, 16 patients (18.8%) underwent proctectomy for the treatment of perianal or rectovaginal fistulas during follow-up. CONCLUSIONS: In a population-based inception cohort of CD, one-fifth of patients were diagnosed with at least 1 perianal or rectovaginal fistula. The cumulative probability of perianal or rectovaginal fistulizing disease has decreased over time.

Original languageEnglish (US)
Pages (from-to)1054-1060
Number of pages7
JournalInflammatory bowel diseases
Volume25
Issue number6
DOIs
StatePublished - May 4 2019

Fingerprint

Rectovaginal Fistula
Crohn Disease
Population
Incidence
Medical Records

Keywords

  • Crohn’s disease
  • natural history
  • perianal fistula
  • rectovaginal fistula

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

Cite this

Update on the Natural Course of Fistulizing Perianal Crohn's Disease in a Population-Based Cohort. / Park, Sang Hyoung; Aniwan, Satimai; Scott Harmsen, W.; Tremaine, William J.; Lightner, Amy; Faubion, William Alvis; Loftus, Jr, Edward Vincent.

In: Inflammatory bowel diseases, Vol. 25, No. 6, 04.05.2019, p. 1054-1060.

Research output: Contribution to journalArticle

Park, Sang Hyoung ; Aniwan, Satimai ; Scott Harmsen, W. ; Tremaine, William J. ; Lightner, Amy ; Faubion, William Alvis ; Loftus, Jr, Edward Vincent. / Update on the Natural Course of Fistulizing Perianal Crohn's Disease in a Population-Based Cohort. In: Inflammatory bowel diseases. 2019 ; Vol. 25, No. 6. pp. 1054-1060.
@article{17f3a85f7bf142c1b79a054012fb1830,
title = "Update on the Natural Course of Fistulizing Perianal Crohn's Disease in a Population-Based Cohort",
abstract = "BACKGROUND: This study sought to re-estimate the cumulative incidence of perianal or rectovaginal fistulas and the associated proctectomy rate in the prebiologic era vs the biologic era using a population-based cohort of Crohn's disease (CD) patients. METHODS: The medical records of 414 residents of Olmsted County, Minnesota, who were diagnosed with CD between 1970 and 2010 were reviewed. The cumulative incidence of perianal or rectovaginal fistulas from time of CD diagnosis and the cumulative rate of proctectomy from date of first perianal or rectovaginal fistula diagnosis were estimated using the Kaplan-Meier method. RESULTS: Eighty-five patients (20.5{\%}) diagnosed with CD between 1970 and 2010 had at least 1 perianal or rectovaginal fistula episode between January 1, 1970, and June 30, 2016. The cumulative incidence of perianal or rectovaginal fistulas was 18{\%} after 10 years, 23{\%} after 20 years, and 24{\%} after 30-40 years from CD diagnosis. The cumulative incidence of perianal or rectovaginal fistulas was significantly lower in patients diagnosed in 1998 or after than in patients diagnosed before 1998 (P = 0.03, log-rank). Among 85 patients developing perianal or rectovaginal fistulas, 16 patients (18.8{\%}) underwent proctectomy for the treatment of perianal or rectovaginal fistulas during follow-up. CONCLUSIONS: In a population-based inception cohort of CD, one-fifth of patients were diagnosed with at least 1 perianal or rectovaginal fistula. The cumulative probability of perianal or rectovaginal fistulizing disease has decreased over time.",
keywords = "Crohn’s disease, natural history, perianal fistula, rectovaginal fistula",
author = "Park, {Sang Hyoung} and Satimai Aniwan and {Scott Harmsen}, W. and Tremaine, {William J.} and Amy Lightner and Faubion, {William Alvis} and {Loftus, Jr}, {Edward Vincent}",
year = "2019",
month = "5",
day = "4",
doi = "10.1093/ibd/izy329",
language = "English (US)",
volume = "25",
pages = "1054--1060",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "6",

}

TY - JOUR

T1 - Update on the Natural Course of Fistulizing Perianal Crohn's Disease in a Population-Based Cohort

AU - Park, Sang Hyoung

AU - Aniwan, Satimai

AU - Scott Harmsen, W.

AU - Tremaine, William J.

AU - Lightner, Amy

AU - Faubion, William Alvis

AU - Loftus, Jr, Edward Vincent

PY - 2019/5/4

Y1 - 2019/5/4

N2 - BACKGROUND: This study sought to re-estimate the cumulative incidence of perianal or rectovaginal fistulas and the associated proctectomy rate in the prebiologic era vs the biologic era using a population-based cohort of Crohn's disease (CD) patients. METHODS: The medical records of 414 residents of Olmsted County, Minnesota, who were diagnosed with CD between 1970 and 2010 were reviewed. The cumulative incidence of perianal or rectovaginal fistulas from time of CD diagnosis and the cumulative rate of proctectomy from date of first perianal or rectovaginal fistula diagnosis were estimated using the Kaplan-Meier method. RESULTS: Eighty-five patients (20.5%) diagnosed with CD between 1970 and 2010 had at least 1 perianal or rectovaginal fistula episode between January 1, 1970, and June 30, 2016. The cumulative incidence of perianal or rectovaginal fistulas was 18% after 10 years, 23% after 20 years, and 24% after 30-40 years from CD diagnosis. The cumulative incidence of perianal or rectovaginal fistulas was significantly lower in patients diagnosed in 1998 or after than in patients diagnosed before 1998 (P = 0.03, log-rank). Among 85 patients developing perianal or rectovaginal fistulas, 16 patients (18.8%) underwent proctectomy for the treatment of perianal or rectovaginal fistulas during follow-up. CONCLUSIONS: In a population-based inception cohort of CD, one-fifth of patients were diagnosed with at least 1 perianal or rectovaginal fistula. The cumulative probability of perianal or rectovaginal fistulizing disease has decreased over time.

AB - BACKGROUND: This study sought to re-estimate the cumulative incidence of perianal or rectovaginal fistulas and the associated proctectomy rate in the prebiologic era vs the biologic era using a population-based cohort of Crohn's disease (CD) patients. METHODS: The medical records of 414 residents of Olmsted County, Minnesota, who were diagnosed with CD between 1970 and 2010 were reviewed. The cumulative incidence of perianal or rectovaginal fistulas from time of CD diagnosis and the cumulative rate of proctectomy from date of first perianal or rectovaginal fistula diagnosis were estimated using the Kaplan-Meier method. RESULTS: Eighty-five patients (20.5%) diagnosed with CD between 1970 and 2010 had at least 1 perianal or rectovaginal fistula episode between January 1, 1970, and June 30, 2016. The cumulative incidence of perianal or rectovaginal fistulas was 18% after 10 years, 23% after 20 years, and 24% after 30-40 years from CD diagnosis. The cumulative incidence of perianal or rectovaginal fistulas was significantly lower in patients diagnosed in 1998 or after than in patients diagnosed before 1998 (P = 0.03, log-rank). Among 85 patients developing perianal or rectovaginal fistulas, 16 patients (18.8%) underwent proctectomy for the treatment of perianal or rectovaginal fistulas during follow-up. CONCLUSIONS: In a population-based inception cohort of CD, one-fifth of patients were diagnosed with at least 1 perianal or rectovaginal fistula. The cumulative probability of perianal or rectovaginal fistulizing disease has decreased over time.

KW - Crohn’s disease

KW - natural history

KW - perianal fistula

KW - rectovaginal fistula

UR - http://www.scopus.com/inward/record.url?scp=85058144806&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058144806&partnerID=8YFLogxK

U2 - 10.1093/ibd/izy329

DO - 10.1093/ibd/izy329

M3 - Article

C2 - 30346531

AN - SCOPUS:85058144806

VL - 25

SP - 1054

EP - 1060

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 6

ER -