P252 Elevated C-reactive protein level during clinical remission can predict poor outcomes in patients Crohn's disease
Bibliographic record
Abstract
Background: Intestinal mucosal damage in Crohn's disease (CD) is believed to progress even in patients showing clinical remission. We aimed to investigate the difference in the long-term prognosis of CD patients in clinical remission depending on serum C-reactive protein (CRP) levels during clinical remission. Methods: A total of 339 CD patients in clinical remission (defined by Crohn's disease activity index less than 150) for more than 6 months between January 2008 and December 2010 were enrolled in this study. Clinical outcomes represented by CD-related hospitalization, intestinal resection, perianal surgery, intestinal complications, and step-up of medical therapy were compared between normal CRP group and elevated CRP group during clinical remission. Results: There were 150 patients with normal CRP through 6 months of clinical remission and 189 patients who showed elevated CRP at least once during 6 months of clinical remission. During follow-up (median, 7.9 years [interquartile range, 6.8–8.0]), the Kaplan-Meier analysis with the log-rank test showed the superiority of the normal CRP group compared with the elevated CRP group in terms of CD-related hospitalization-free survival (Figure 1A, p=0.007) and intestinal resection-free survival (Figure 1B, p=0.046). Figure 1. Kaplan-Meier hospitalization-free survival curves (A) and intestinal resection-free survival curves (B). In multivariate analysis, elevated CRP and Montreal penetrating behavior were associated with increased risk of CD-related hospitalization (adjusted hazard ratio [aHR] 1.787; 95% confidence interval [CI] 1.245–2.565, p=0.002, and aHR 2.175; 95% CI 1.489–3.177, p<0.001, respectively). In addition, elevated CRP, Montreal structuring behavior, Montreal penetrating behavior, and use of immunomodulators were associated with increased risk of intestinal resection (aHR 1.726; 95% CI 1.003–2.969, p=0.049, aHR 2.722; 95% CI 1.223–6.058, p=0.014, aHR 4.149; 95% CI 2.117–7.907, p<0.001, and aHR 2.147; 95% CI 1.076–4.284, p=0.030, respectively). Conclusions: Even if patients with CD are in clinical remission, elevated CRP showed a significant association with poor prognosis represented by a higher risk of subsequent CD-related hospitalization and intestinal resection. More vigilant monitoring and therapeutic strategy are required for CD patients in remission, but with high CRP to improve long-term prognosis.
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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 | 0.001 | 0.002 |
| 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 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".