P629 Evolution of disease phenotype, time to biological therapy and medium-, long-term surgery rates in Crohn’s disease patients in Western Hungary – a population-based study between 2007–2018, data from the Veszprem county cohort
Notice bibliographique
Résumé
Abstract Background The number of prospective population-based studies evaluating the natural disease course and surgical outcomes of Crohn’s disease(CD) are still limited from Eastern Europe. The present study is a continuation of the Veszprem IBD population-based cohort with a follow-up of the incidence and disease course of IBD since 1977. Our aim was to evaluate disease course by examining progression in disease phenotype, time to biological therapy and surgery rates in a prospective population-based database from Veszprem Province, including incident CD patients diagnosed between January1,2007 and December31,2018. Methods Data of 421 incident CD patients were analyzed(male/female:237/184; median age at diagnosis:29 years(y)[IQR: 21–42]). Both in-hospital and outpatient records were collected and comprehensively reviewed at diagnosis and during clinical follow-up. The mean length of follow-up was 8.53y(SD: 3.3). Probability of medium-, long-term change in disease course and surgical outcomes were analyzed. Results Disease location was ileal(L1), colonic(L2) in and ileo-colonic(L3) in 29.7%/24.5%/45.8% of patients at diagnosis. At the end of follow-up(8.53y), disease location was 27.1%/22.8%/50.1%(L1/L2/L3). The proportion of patients with upper gastrointestinal manifestation remained stable(7.6% and 8.1%), while perianal disease increased from 13.5% to 19% by the end of follow-up. Disease behavior at diagnosis was luminal(B1) in 62.5% of the patients. The probability of disease behavior progression from luminal into stenosing or penetrating phenotype was 11.9%(SE:1.7) at 3 years, 13.2%(SE:1.7) at 5 years and 17.6%(SE:1.7) at 10 years.Figure 1. The Probability of receiving biological therapy after diagnosis was 20.9%(SE:2.0) at 5 years and 28.8%(SE:2.0) at 10 years in this cohort. Overall resective surgery rate was 29.5% in the total population, while perianal surgery rate was 31.3% in patients with perianal disease at the end of follow-up. The probability of resective surgery was 20.7%(SE:2.0) at 1 year, 26.1%(SE:2.2) at 5 years and 30.7%(SE:2.4) at 10 years.Figure 2. For the probability of first perianal surgery among patients with perianal disease see Figure 3. Conclusion The probability of progression in disease behavior was lower compared to data from previous decades and similar to results from recent pan-European population-based data.(Burisch 2018, JCC). One-year surgery rates after diagnosis were considerably higher compared to previous data from our cohort or compared to Western and Northern European centers.(Lakatos 2011, IBD). Medium-term(5y) surgery rates were similar(~20%) compared to recent Hungarian and European data, while long-term(10y) rates decreased compared to data from previous decades.(Lakatos 2011,IBD; Lakatos 2012,AJG).
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) | 0,001 | 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 ».