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Vaillant S, Guillo L, Michot N, D'Amico F, Germain A, Danese S, Baumann C, Rousseau H, Quilliot D, Peyrin-Biroulet L. Predictors for short bowel syndrome in Crohn's disease. Dig Liver Dis 2020; 52:1455-1460. [PMID: 32938546 DOI: 10.1016/j.dld.2020.08.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/06/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Patients with Crohn's disease (CD) are at risk for short bowel syndrome (SBS). We investigated independent predictors for SBS in these patients to allow the development of preventive strategies. METHODS All adult patients seen at the Nancy University hospital for CD or SBS between 2012 and 2019 were eligible for inclusion in this case-control study. Each CD patient with SBS was matched to 9 controls. RESULTS 410 CD patients were included (369 without SBS and 41 with SBS). Subjects with SBS underwent significantly more bowel resections (median value of 3 vs 1, p<0.0001) and median time before the first surgery was not different than controls (6 vs 4 years, p=0.59). A higher need for parenteral support was found in end-jejunostomy SBS than in jejunocolic and jejunoileal SBS (70.6% vs 25% and 0%, p=0.0031). Montreal B1 behavior (OR 0.02, CI 95% 0-0.08) and budesonide treated-patients (OR=0.03, CI 95% 0.003-0.2) were at lower risk of SBS, while IV steroid treated-patients were at higher risk (OR=8.5, CI 95% 3.0-24.9). CONCLUSION Montreal B1 behavior, IV steroids and budesonide use are influencing predictors for this complication. These predictors should be assessed in daily clinical practice to prevent SBS occurrence.
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Affiliation(s)
- Simon Vaillant
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, 1 Allée du Morvan, 54511 Vandoeuvre-lès-Nancy, France; Nutritional Assistance Department, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Lucas Guillo
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, 1 Allée du Morvan, 54511 Vandoeuvre-lès-Nancy, France; Department of Gastroenterology, University Hospital of Marseille Nord, University of Aix-Marseille, Marseille, France
| | - Niasha Michot
- Nutritional Assistance Department, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Ferdinando D'Amico
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, 1 Allée du Morvan, 54511 Vandoeuvre-lès-Nancy, France; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Adeline Germain
- Department of Surgery, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Silvio Danese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, Rozzano Milan, Italy
| | - Cédric Baumann
- DRCI, MPI department, Methodology, data management and statistic Unit, University Hospital of Nancy, Vandœuvre-Lès-Nancy, France
| | - Hélène Rousseau
- DRCI, MPI department, Methodology, data management and statistic Unit, University Hospital of Nancy, Vandœuvre-Lès-Nancy, France
| | - Didier Quilliot
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, 1 Allée du Morvan, 54511 Vandoeuvre-lès-Nancy, France; Nutritional Assistance Department, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, 1 Allée du Morvan, 54511 Vandoeuvre-lès-Nancy, France.
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