P240 Low surgery rates first year after diagnosis in Crohn’s disease; results from a large population-based inception cohort - the IBSEN III study
Notice bibliographique
Résumé
Abstract Background Surgery rates in Crohn’s disease (CD) have declined during recent years, in parallel with the introduction and increased use of biological treatment. The aim of this study was to describe the use of first-line biologic therapy and to estimate the intra-abdominal surgery rate during the first year after the CD diagnosis. Methods The Inflammatory Bowel Disease in South-Eastern Norway III (IBSEN III) study is a population-based inception cohort with a prospective follow-up of newly diagnosed inflammatory bowel disease patients from the South-Eastern Health Region of Norway included in the period 2017 to 2019. Five hundred and seven patients ≥18 years were diagnosed with CD and those attending the one-year follow-up visit were included in this study. Clinical data, including Montreal classification, were registered at time of diagnosis. At the one-year follow-up, use of biologic therapy and need for CD-related intra-abdominal surgery since diagnosis were registered. Kaplan-Meier plots estimated the cumulative incidence of first-line biologic therapy and intra-abdominal surgery. Results A total of 431/507 (85%) CD patients attended the one-year follow-up and were included, 54.8% female, median age 37 years (range 18-80). At diagnosis 218 (50.6%) presented with ileal disease location, 76 (17.6%) colonic and 137 (31.8%) ileocolonic disease location, while 11 (2.6%) also had upper gastrointestinal involvement. The majority, 351 (81.4%), had a non-stricturing non-penetrating disease behavior, 70 (16.2%) a stricturing and 10 (2.3%) a penetrating disease behavior, while 17 (3.9%) also had perianal disease. Within one year of follow-up, 165 (38.7%) received at least one biologic therapy (60.6% infliximab, 35.8% adalimumab and 3.6% vedolizumab). Seven patients (1.6%) underwent perianal surgery and 21 (4.9%) had intra-abdominal surgery within the first year. Three of these were diagnosed during their primary surgery. Time from diagnosis to start of first-line biologic therapy and first intra-abdominal surgery is shown in Figure 1 and Figure 2, respectively. Figure 1: Kaplan-Meier plot showing cumulative incidence of first-line biologic therapy. Figure 2: Kaplan-Meier plot showing cumulative incidence of Crohn's related intra-abdominal surgery. Conclusion In the IBSEN III cohort, the rate of intra-abdominal surgery during the first year of disease was low (4.9%) compared to a previous population-based study from the same geographic area during the pre-biologic era, the IBSEN study, where the surgery rate was reported as 15.9 %.1 We hypothesize that a large preponderance of patients presenting with milder phenotypes at diagnosis combined with high use of biologicals contribute to the low surgery rates.
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 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| 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 | 0,001 |
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 ».