Your browser doesn't support javascript.
loading
Applicability and indications of colonoscopic screening for Crohn's disease in patients with fistula-in-ano / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery ; (12): 1030-1034, 2016.
Article in Chinese | WPRIM | ID: wpr-323538
ABSTRACT
<p><b>OBJECTIVE</b>To determine the indications of colonoscopic screening for Crohn's disease in patients with fistula-in-ano.</p><p><b>METHODS</b>Clinical data of 302 patients with perianal fistula who received colonoscopy examination from January 2010 to December 2013 in the Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University were analyzed retrospectively. Parameters for differentiating perianal Crohn's disease from nonspecific fistulae were screened by logistic regression analysis. A regression mathematical model was established for the prediction of perianal Crohn's disease.</p><p><b>RESULTS</b>A total of 302 patients received colonoscopy examination, and Crohn's disease was found in 16 patients (CD group). Results of univariate analysis on 26 parameters of clinical manifestation, laboratory and radiological examination revealed that differences in 11 clinical parameters between the CD group and non-CD group were statistically significant(all P<0.05), including age, BMI, abdominal pain, non-specific symptoms, multiple fistula, complex anal fistula, neutrophil count, platelet count, activated partial thromboplastin time, hemoglobin concentration and serum albumin concentration. Multivariate analysis revealed that age≤40 years (OR=14.464, 95% CI 1.143-183.053, P=0.039), BMI<24.0 kg/m(OR=8.220, 95% CI1.005-67.200, P=0.049), abdominal pain (OR=13.148, 95% CI 1.110-155.774, P=0.041), complex anal fistula (OR=7.056, 95% CI1.166-42.688, P=0.033) and elevated platelet count (OR=1.012, 95% CI 1.004-1.0194, P=0.003) were independent risk factors for discovery of Crohn's disease by colonoscopy. Area under the ROC curve of the regression mathematical model based on factors mentioned above was 0.921, indicating that the model was highly predictive. The sensitivity and specificity of this model was 81.3% and 86.7% respectively when the optimal diagnostic cut-off point was established at 0.856.</p><p><b>CONCLUSIONS</b>Parameters that predict Crohn's disease in patients with perianal fistula include age, BMI, abdominal pain, classification of fistula and platelet count. Colonoscopy is recommended for patients at high risk.</p>
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Partial Thromboplastin Time / Platelet Count / Blood / Crohn Disease / Abdominal Pain / Body Mass Index / Epidemiology / Multivariate Analysis / Retrospective Studies / Risk Factors Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors / Screening study Limits: Adult / Female / Humans / Male Language: Chinese Journal: Chinese Journal of Gastrointestinal Surgery Year: 2016 Type: Article

Similar

MEDLINE

...
LILACS

LIS

Full text: Available Index: WPRIM (Western Pacific) Main subject: Partial Thromboplastin Time / Platelet Count / Blood / Crohn Disease / Abdominal Pain / Body Mass Index / Epidemiology / Multivariate Analysis / Retrospective Studies / Risk Factors Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors / Screening study Limits: Adult / Female / Humans / Male Language: Chinese Journal: Chinese Journal of Gastrointestinal Surgery Year: 2016 Type: Article