P-128 Risk Factors for Postoperative Endoscopic Recurrence in Crohnʼs Disease
Bibliographic record
Abstract
Surgical therapy for Crohn's disease (CD) does not result in cure. Clinical and endoscopic recurrence are frequently found in long-term follow up of CD patients. Phenotype and histopathological characteristics, medication on the pre and postoperative scenario and surgical technique details, among other variables, can influence the rates of postoperative endoscopic recurrence after resections. The aim of this study was to analyze the rates of endoscopic recurrence in a cohort of CD patients, and define risk factors for its occurrence. Multicenter, observational and retrospective study, with CD patients, submitted to ileocecal resection and had endoscopic follow-up for recurrence analysis. Analyzed variables: demographic data, Montreal classification, associated procedures, type of operation (conventional or laparoscopic), type of anastomosis (stapled or hand-sewn), residual CD, medication on the pre and postoperative setting, granulomas, and presence of recurrence according to the Rutgeerts' score. Endoscopic recurrence was defined as Rutgeerts' score ≥ i-2. Patients were classified into 2 groups, according to the presence or not of postoperative endoscopic recurrence on the first colonoscopy after the operations. The studied variables were tested to analyze risk factors for recurrence. Statistical analysis: exact Fischer test or Mann-Whitney (qualitative variables), and Student's t test or Mann-Whitney (quantitative variables). Statistical significance was considered with P < 0.05. A total of 85 patients were included, 48 men (56.8%), with median age at diagnosis of 33,1 years (14–63) and CD duration of 84.5 (2–300) months. From these, 28 (32.9%) had endoscopic recurrence, and 57 (67.1%) had not. There was no significant difference between the groups in relation to age (P = 0.753), CD duration (P = 0.193), length of surgical specimen (P = 0.536), granulomas (P = 1.000), CD location (P = 0.792), phenotype of the disease (P = 0.329), smoking (P = 0.565), type of anastomosis (P = 1.000) and perianal disease (P = 1.000). The only risk factor with significant difference between the groups was preoperative use of corticosteroids (50% on patients with recurrence and 26,5% on the patients with endoscopic normality, P = 0.044). Preoperative use of corticosteroids was the only risk factor identified for postoperative endoscopic recurrence in this study. There was no influence of disease characteristics, pathologic features or surgical technique details on the recurrence rates.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".