P341 Clinical Characteristics and Outcomes of Crohn’s Disease with Upper Gastrointestinal Involvement: A Comprehensive Retrospective Cohort Study
Bibliographic record
Abstract
Abstract Background Crohn's Disease (CD) affects the entire gastrointestinal tract, predominantly involving the terminal ileum and colon. However, the incidence and implications of upper gastrointestinal tract involvement in CD are often underestimated and underreported, especially in Asian populations. This study provides a comprehensive evaluation of the clinical characteristics and outcomes associated with UGI involvement in CD. Methods We conducted a retrospective cohort study at Chang Gung Memorial Hospital, Linkou, from January 2001 to June 2023, including CD patients with consistent follow-up records. Patients were categorized into two groups based on UGI involvement: Montreal L4 and non-L4. Comparative analyses were performed between the groups regarding baseline characteristics, new-onset complications post L4 disease diagnosis, and clinical outcomes. Results The study included 223 CD patients, 114 in the L4 group and 109 in the non-L4 group, with an average follow-up of 40.6 months. Initially, the L4 group showed higher smoking prevalence (21.1% vs. 5.5%, P<0.001), higher Crohn’s Disease Activity Index (CDAI) scores (302.6±85.6 vs. 272.8±106.3, P=0.023), increased stricture disease (Montreal B2) incidence (55% vs. 48.2%, P<0.001), and more frequent use of biologics (12.3% vs.3.7%, P=0.021) and proton pump inhibitors (64.9% vs. 52%, P=0.014). They also had lower albumin levels (3.6±0.8 vs. 3.9±0.7, P=0.011) and reduced peri-anal (14.9% vs. 26.8%, P=0.026) and fistulizing disease incidences (14% vs. 26.6%, P=0.016). At follow-up end, the L4 group continued to exhibit higher CDAI scores (153.6±98.7 vs. 114.4±71.8, P = 0.001), increased hospitalization rates (0.6±1.1 vs. 0.3±0.5 times/year, P=0.009), elevated C-reactive protein levels (15.2±37.8 vs. 6.9±15.1, P=0.036), and decreased albumin levels (4±0.7 vs. 4.2±0.4, P=0.018). Though they had a lower incidence of new-onset perianal fistula (6.7% vs. 3.7%, P=0.041), the L4 group had higher incidences of most new-onset CD-related complications, including strictures (44% vs. 20.2%, P<0.001), enter enteral fistulae (11.9% vs. 3.5%, P=0.036), and intraabdominal abscesses (17.4% vs. 5.3%, P=0.009). Conclusion CD with UGI involvement is associated with higher disease activity and an increased risk of IBD-related complications. Comprehensive assessments at diagnosis and aggressive treatments are crucial for these patients to mitigate poorer 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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".