DOP104 International differences in pre-operative characteristics and postoperative management in patients with Crohn’s disease following ileocolic resection: a report from the IMPACT consortium
Notice bibliographique
Résumé
Abstract Background Intestinal surgery is a key treatment for Crohn’s disease (CD). Large cohort data on perioperative management are vital to improve postoperative outcomes. This study aimed to assess and compare preoperative characteristics and postoperative management across three large prospective cohort studies of CD patients following ileocolic resection (ICR). Methods The IMPACT consortium (International Multidisciplinary Research Collaboration on Postoperative IBD) is an intercontinental initiative focused on postoperative inflammatory bowel disease research. Prospective data were used from three ongoing cohort studies with a comparable set-up and data collection, including CD patients who underwent ICR between December 2009 and September 2024, originating from the Netherlands (NL), North-America (Canada [CAN] and United States of America [USA]) and France (FR). Pre-operative characteristics, clinical risk profiles for post-operative recurrence (POR), use of postoperative prophylactic medication and performance of endoscopic evaluation were compared between the involved countries. Results 1,601 patients with CD following ICR were included (455 NL, 149 CAN, 307 USA, 690 FR)(48.3% male; median age at surgery 33.7 years [IQR 25.8-46.6])(Table 1). Active smoking rates were higher in Europe (NL: 26.2%; FR: 32.8%) compared with North America (CAN: 13.2%; USA: 8.2%). Prior small bowel resections were more common in North American (CAN: 29.5%; USA: 27.0%) compared with Europe (NL: 20.0%; FR: 17.0%). Preoperative biological exposure was lower in Canada (55.7%) and the USA (56.0%) compared with the Netherlands (69.2%) and France (75.5%). A higher proportion of Dutch patients had non-complicated CD (Montreal B1) at surgery (18.4%) compared to other countries (CAN: 1.4%; USA: 2.3%; FR: 4.5%). Overall, 72.7% were considered high-risk for POR, with the lowest rates in the Dutch cohort (62.2%) compared to the other countries (CAN: 73.8%; USA: 77.9%; FR: 77.1%). Postoperative prophylactic medication was initiated in 42.2% with higher rates in the USA (45.9%) and France (51.0%) compared with the Netherlands (28.5%) and Canada (34.9%). Details on postoperative prophylactic medication use are provided in Table 2. An endoscopic evaluation within one year postoperatively was performed in 89.0% of patients, with higher rates (>85%) in the Netherlands, Canada, and France, compared with the USA (66.9%). Conclusion This first study of the IMPACT consortium revealed notable differences in preoperative characteristics, risk profiles for postoperative recurrence, use of prophylactic medication, and postoperative endoscopic evaluation across Europe and North America. Further analyses will include the assessment of rates and factors associated with endoscopic recurrence. References 1.Gionchetti P, Dignass A, Danese S, et al. ; ECCO . 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: Part 2: surgical management and special situations. J Crohns Colitis. 2017;11:135–149 2.Lamb CA, Kennedy NA, Raine T, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019;68:s1–s106.
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 | 0,003 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 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) | 0,001 | 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 ».