Evolution and Prognosis of Digestif Fistulas in Crohn's Disease (CD) Other Than Ano-Perineal Manifestations (APM)
Bibliographic record
Abstract
Background and Objectives: Crohn's disease (CD) is a chronic inflammatory disease of the intestine. It can evaluate by the occurrence of intestinal complications in particular fistulas whose management can be medical or surgical. The objective of our work is to specify the evolutionary modalities, as well as the predictive factors of bad prognosis. Patients and Methods: this is a monocentric, descriptive and analytical retrospective study conducted in a hepato gastroenterology department including patients with fistulizing Crohn's disease, outside ano perineal fistulas from 1990 to 2023. Statistical analysis was performed using SPSS22.0 software. Results: Of a total of 960 patients, 38 had fistulizing CD. 65% of our patients were classified as A3 according to the Montreal classification, and 34% as A2. They were 24 women with a sex ratio of 1.71 F/H. The type of fistula was Greco-Greatic in 4 patients (10.5%), Greco-Colic in 5 patients (13%), Entero-Cutaneous in 12 patients (31.5%), Gastro-Colic in 3 patients (7.9%), Interdigestive and Entero-Cutaneous in 10 patients (26%), Interdigestive and Greco-Vesical in 2 patients. All our patients had benefited from a bi-antibiotic therapy, 33 had benefited from surgical resection. Postoperative treatments were based on therapeutic abstention in 5 patients (13.1%), immunosuppressive treatment in 18 patients (47%), anti TNF treatment in 7 patients (18%). The endoscopic recurrence rate 6 months after treatment was 32.5%. In univariate analysis, the factors influencing the evolution of fistulizing crohn's disease were the number of fistulas and age with p values lower than 0.05 (respectively 0.022 and 0.009). Conclusion: Digestive fistulas represent a complication during CD, which pose a problem of medical-surgical management and have an impact on the quality of life of the patients. Our study showed that age (p=0.022) and the number of fistulas (p=0.009) represent the factors influencing the natural history of fistulizing CD.
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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 | 0.000 |
| 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 | 0.000 |
| 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".