P256 High disease burden of CROHN’S DISEASE (CD) in a Latin American IBD reference center
Bibliographic record
Abstract
Abstract Background CD is a multifactorial, heterogeneous, disabling condition, with high surgical rates and complications. Best knowledge of regional clinical features may favor awareness, evolution and healthcare resources. AIM: to describe by means a retrospective study in a Latin American IBD reference center, clinical characteristics of our CD casuistic, and the risk for surgery. Methods data of CD patients (pts) assisted from 1990-June 2020 (CD duration≥1 yr), registered in a database, were revised and reclassified (by Montreal) in Age at diagnosis (A)A1:≦16yrs, A2:17–40, A3:>40, Behavior (B) B1, stricturing (B2), penetrating (B3), perianal modifier (p), Location (L) L1: ileal, L2: colonic, L3: ileocolonic, L4: upper GI: isolated or combined. Incidence rates of progression and surgery (major abdominal surgery and/or bowel resection) were estimated (Kaplan Meier). Results 598 CD pts (M 313, F 285), CD median duration 13.9 yrs (IQR 7.1–21.2) were available for analysis. Montreal A1: n 93 (15.6%), A2: n 335 (56.0%), A3: n 170 (28.4%). Behavior patterns rates within 90 days from diagnosis were: B1: n 523 (87.5%), B2: n 52 (8.7%), B3: n 23 (3.8%). Location L1: n 52 (8.7%), L2: n 368 (61.5%) L3: n 176 (29.4), L4: n 2 (0.33%) and L4 combined with L1, L2, L3: n 47 (7.9%). Complicated initial behavior (or progression to complications) was observed in 252/598 (42.1%). Rates of cumulative incidence of developing either stricturing or penetrating complications at 1, 3, 5, 10 yrs were: 20.9% (95%CI 17.9–24.4), 31.4% (95%CI 27.7–35.4), 37.0% (95%CI 33.0–41.3), 48.4% (95%CI 43.5–53.4) respectively; by each complication were for B2: 15.22%, 22.9%, 27.0%, 34.1%, and B3: 6.7%, 11.1%, 14.6%, 21.9%, respectively. Both complications in same patient were present in 54 (9%) pts. B3 was more prevalent in L3 (40.8%), B2 in L1 (56.3%), (p=0.00001 for both) vs L2 (16.7%, 22.2% respectively). Perianal disease (p) was more frequent in L2 (53.2% p<0.024) vs. the rest of locations (L1: 39.6%, L3: 40.8%, half of L4). CD location progression was less frequent (5%, mainly progression on small bowel). Considerable proportions of pts needed early IV steroids, immunosuppressants (58%), Biologics (at least one: 44%) and optimization. Major surgery was performed in 304/598 pts (50.8%),≥1 in 20%; 9.8% needed permanent stoma. Cumulative incidence rates of major surgery at 90 days, 1, 3, 5, 10 yrs were 5.7%, 11.7%, 23.4%, 29.1%, 42.0%. Patterns B2, B3, L1, L3, L4, A2, also (unusual) A3 were substantial contributors. Conclusion We found high disease burden in this Latin American referral IBD cohort with a large proportion of patients presenting/developing a complicated disease behaviour, with high need for immunosupressive/biological therapy and high rates of major surgery.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".