P292 Perianal disease: far beyond a simple feature of Crohn's disease
Notice bibliographique
Résumé
Background: Perianal disease is a significant source of morbidity and impairs the quality of life of affected patients with Crohn's disease (CD). We aimed to access the impact of perianal involvement in disease outcomes. Methods: Retrospective unicentric study including patients with definite diagnosis of CD with a follow up of at least 12 months. All patients with documented perianal disease (anal fistula and perianal abscess) were included while controls were randomly selected. Clinical and analytical variables were assessed, and disease outcomes (hospitalization, surgery, need for steroids and behavior progression) during the follow-up were reviewed. Statistical analysis was performed using SPSS v21.0 and a two-tailed p value <0.05 was defined as indicating statistical significance. Results: Included 198 patients, of which 53 (26,8%) had perianal disease. Patients had a mean age of 41±13 years and 52,5% were females. When comparing patients with and without perianal disease, no significant differences were found between groups regarding gender, age, Montreal classification at diagnosis (age, location and behavior-excluding perianal involvement), family history and smoking habits. Patients with perianal disease had more frequently proctitis at diagnosis (32.1% vs 5,6%, p<0.01), and this difference was statistically significant. During follow-up, these patients were more frequently submitted to surgery (excluding perianal disease interventions) (41.5% vs 24.8%, p=0.02), were more frequently hospitalized (66.0% vs 49.7%, p=0.04), had longer in-stay (23 days vs 12 days, p=0.01) and were more frequently treated with anti-TNF agents (56.9% vs 38.1%, p=0.02). Also, these patients were more likely to have a change in disease behavior, with development of penetrating disease (18.9% vs 6.9%, p=0.01). No differences were found between the two groups regarding extra-intestinal manifestations, need for steroids, time from diagnosis to first surgery and development of stricturing disease. Conclusions: Patients with perianal disease had significantly higher disease burden, with greater need for surgery, hospitalization and more frequently displayed penetrating disease progression. These results support that perianal CD represents a particularly aggressive disease phenotype that should be treated aggressively, not only due to the perianal involvement but also, very importantly, because of its association with worse outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».