P292 Perianal disease: far beyond a simple feature of Crohn's disease
Bibliographic record
Abstract
Background: Perianal disease is a significant source of morbidity and impairs the quality of life of affected patients with Crohn's disease (CD). We aimed to access the impact of perianal involvement in disease outcomes. Methods: Retrospective unicentric study including patients with definite diagnosis of CD with a follow up of at least 12 months. All patients with documented perianal disease (anal fistula and perianal abscess) were included while controls were randomly selected. Clinical and analytical variables were assessed, and disease outcomes (hospitalization, surgery, need for steroids and behavior progression) during the follow-up were reviewed. Statistical analysis was performed using SPSS v21.0 and a two-tailed p value <0.05 was defined as indicating statistical significance. Results: Included 198 patients, of which 53 (26,8%) had perianal disease. Patients had a mean age of 41±13 years and 52,5% were females. When comparing patients with and without perianal disease, no significant differences were found between groups regarding gender, age, Montreal classification at diagnosis (age, location and behavior-excluding perianal involvement), family history and smoking habits. Patients with perianal disease had more frequently proctitis at diagnosis (32.1% vs 5,6%, p<0.01), and this difference was statistically significant. During follow-up, these patients were more frequently submitted to surgery (excluding perianal disease interventions) (41.5% vs 24.8%, p=0.02), were more frequently hospitalized (66.0% vs 49.7%, p=0.04), had longer in-stay (23 days vs 12 days, p=0.01) and were more frequently treated with anti-TNF agents (56.9% vs 38.1%, p=0.02). Also, these patients were more likely to have a change in disease behavior, with development of penetrating disease (18.9% vs 6.9%, p=0.01). No differences were found between the two groups regarding extra-intestinal manifestations, need for steroids, time from diagnosis to first surgery and development of stricturing disease. Conclusions: Patients with perianal disease had significantly higher disease burden, with greater need for surgery, hospitalization and more frequently displayed penetrating disease progression. These results support that perianal CD represents a particularly aggressive disease phenotype that should be treated aggressively, not only due to the perianal involvement but also, very importantly, because of its association with worse outcomes.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".