P488 Perianal Crohn's disease in the biological era
Notice bibliographique
Résumé
The purpose of this study was to characterise perianal disease (PD) in a cohort of patients with Crohn's disease (CD) followed prospectively for 10 years. We performed a prospective cohort study to analyse data from 298 patients, 96 of whom with PD, over the period of 10 years (2007–2017). The characteristics of patients with PD were compared with controls with CD without PD. Perianal lesions were described in abscess, fistula, abscess and/or fistula, fissure, ulcer, fissure and/or ulcer, and stenosis. The Montreal classification was used to characterise CD. The analysis of patients with and without PD showed no difference in sex, behaviour (B1, B2, B3) and involvement of the upper gastrointestinal tract (L4). However, the group of patients with PD had a significantly lower age at onset of symptoms (median=25.5 years, IQR 20.5–34.0) vs. patients without PD (median=30.5 years, IQR 22.0–41.0) (p = 0.018), higher colon involvement (L2 + L3 vs. L1) (OR = 2.64, p = 0.001), higher rectal involvement (OR = 5.60, p < 0.001), higher rate of abdominal resection surgery (OR = 1.70, p = 0.046), and higher rate of biological therapy (OR = 2.86, p < 0.001). In patients with PD, 42 (43.8%) had abscess, 62 (64.6%) had fistula, 69 (71.9%) had abscess and/or fistula, 29 (30.2%) had fissure, 4 (4.2%) had ulcer, 33 (34.4%) had fissure and/or ulcer, 8 (8.3%) had anal stenosis; 37 (38.5%) had L1 involvement, 23 (24%) had L2, 36 (37.5%) had L3; 9 (9.4%) had L4 involvement; 38 (39.6%) had rectal involvement; 49 (51%) had B1 behaviour, 29 (30.2%) had B2; 18 (18.8%) had B3; 70 (72.9%) were under biological therapy; 35 (36.5%) had abdominal surgery and 60 (62.5%) had perianal surgery. In this group of patients, patients with abscesses and/or fistula had a higher rate of abdominal (OR = 3.38, p = 0.022) and perianal surgery (OR = 24.77, p < 0.001); patients with fissure and/or ulcer had a lower rate of abdominal (OR = 0.34, p = 0.025) and perianal surgery (OR = 0.11, p < 0.001); patients with anal stenosis had a higher rectal involvement (OR = 12.87; p = 0.006); and patients with fistula had a higher rate of biological therapy (OR = 3.66, p = 0.005). One third of patients with CD had PD, which is more prevalent in patients with colic involvement. The severity of the perianal location can be inferred by the higher rate of abdominal surgery in this group of patients. Of the perianal lesions, abscess and/or fistula were associated with a worse overall prognosis. These data are in agreement with what is previously described in the literature. Patients with PD had higher rates of biological therapy, with a higher rate in patients with fistula compared with other lesions.
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 | 0,002 |
| 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 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
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 ».