PTH-083 From paris to montreal: evolution of crohn’s disease location and behaviour from childhood to adulthood
Notice bibliographique
Résumé
Introduction Crohn’s disease (CD) is a progressive disorder but the natural history among paediatric onset CD appears different to that of adult onset CD. The long term disease evolution among paediatric onset CD beyond the childhood years is not well characterised. We conducted a single centre cohort study of all paediatric CD patients transitioned to adult care to assess the long term evolution of CD. Method We conducted a retrospective observational, study of all CD patients diagnosed in childhood who were subsequently transferred to the care of an adult gastroenterology unit and had a minimum follow up of 2 years. We examined the case notes for evolution of disease location and behaviour. Disease location and behaviour was characterised using Paris classification at diagnosis and Montreal classification at last follow-up. In addition, we examined variables associated with the need for CD related intestinal resection. We used a paired McNemar’s test to compare disease location and behaviour at diagnosis and most recent follow-up. Results In total, 132 patients were included with a median age at diagnosis of 13 (IQR 11–14) and a median follow up of 11 years (range 4–14). At diagnosis, 23 (17.4%), 39 (29.6%) and 70 (53%) patients had ileal, colonic and ileocolonic disease. In addition, 31 (23.5%) patients had L4a or L4b disease at diagnosis (proximal or distal to the ligament of treitz respectively) and 13 patients (9.8%) had both whilst 27 (20.4%) patients had perianal disease. At diagnosis, only 27 (20.4%) patients had complicated disease behaviour at diagnosis. At the most recent follow-up, the median age was 23.5 (IQR 20–26). Disease location at follow-up was ileal location in 35 (26.5%), colonic in 36 (27.3%) and ileocolonic in 55 (41.7%). Upper GI disease was noted in significantly fewer patients (21, 15.9%, P=0.0018) while 31 patients (23.5%) had perianal disease. More patients had complicated disease behaviour (46 patients, 34.9%, P=0.0001). The mean time to start of thiopurines was 2 years (SD 4.2) and to biologics was 6 (SD 5) years and overall 121 (91.7%) and 84 (63.6%) were exposed to thiopurines and biologics respectively. The cumulative probability (95% CI) of surgery was 0.05 (0.02, 0.11) at 1 year, 0.17 (0.11, 0.24) at 3 years and 0.22 (0.15, 0.30) at 5 years. Neither disease location nor behaviour were associated with the need for intestinal resectional surgery. Conclusion Over the course of an extended follow-up period, there appeared to be changes in both disease location and behaviour in paediatric onset CD. A high rate of exposure to thiopurines and biologics were noted in this cohort. We were unable to identify any variables associated with the need for intestinal surgery.
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 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 ».