P160 Can the Lemann index at diagnosis predict the risk of early surgery in Crohn’s disease?
Notice bibliographique
Résumé
Abstract Background Identifying patients with Crohn’s disease (CD) with rapid disease progression or at high risk for early surgery is a crucial pillar in the treatment decision to ensure optimal patient management. The objective of this study was to assess the correlation between the Lemann index at the time of diagnosis and abdominal surgery in the first year after diagnosis of Crohn’s disease and to find the risk factors for early surgery. Methods This is a retrospective study of all patients with CD followed in our center over a period of 4 years (January 2016- January 2020), and who were evaluated by endoscopy and MRI at baseline. The Lemann Index is a score that measures cumulative damage to digestive tissue from entero-MRI and endoscopy data. It was calculated by noting the previous surgery, the location and extension of the disease and any intestinal complications. The sociodemographic and clinical characteristics of the patients were studied. Hypothesis tests were applied to identify associations. Results 112 patients with CD were included in this study, of which 53.6% were female. The mean age at diagnosis was 33.29 years [15–63]. Active smoking was found in 34 patients (30.4%). Regarding the localization of CD, it was ileal (L1 according to the Montreal classification), colonic (L2), and ileocolonic (L3) in respectively 16.1%, 42.9% and 41%. The disease phenotype was inflammatory (B1) in 60.7%, stricturing (B2) in 21.42%, and penetrating (B3) in 17.85%. Anoperineal manifestations were noted in 24 patients. An upper digestive tract was present in 19.6% of patients. The initial flare was judged to be severe in 33.9% of cases, moderate in 55.4% of cases and mild in 10.7% of cases, with a mean CDAI of 305.21 [115–493]. During the first year after diagnosis of CD, 19.6% of patients (n = 22) required surgical treatment. The indications for surgery were: the presence of an intra-abdominal collection (27.3%), severe acute corticosteroid-resistant colitis (18.2%); ileocaecal stenosis resistant to medical treatment (27.3%) or acute bowel obstruction (27.3%). The LI at diagnosis was much higher in the early surgery group: 5.22 +/- 2.65 vs. 2.63 +/- 1.88; with a statistically significant difference (p = 0.01). A severe initial flare as well as a penetrating phenotype were predictors of early abdominal surgery (p = 0.022, p = 0.024, respectively). Conclusion According to our study, a high Lemann score at diagnosis correlates well with the risk of early surgery in Crohn’s disease. Further, larger-scale studies would be needed to establish the reliability of this test in predicting this risk.
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 | 0,001 | 0,004 |
| 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 | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 ».