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Crohn's disease: a population-based study of surgery in the age of biological therapy.


ABSTRACT:

Purpose

Despite primary conservative therapy for Crohn's disease, a considerable proportion of patients ultimately needs to undergo surgery. Presumably, due to the increased use of biologics, the number of surgeries might have decreased. This study aimed to delineate current case numbers and trends in surgery in the era of biological therapy for Crohn's disease.

Methods

Nationwide standardized hospital discharge data (diagnosis-related groups statistics) from 2010 to 2017 were used. All patients who were admitted as inpatient Crohn's disease cases in Germany were included. Time-related development of admission numbers, rate of surgery, morbidity, and mortality of inpatient Crohn's disease cases were analyzed.

Results

A total number of 201,165 Crohn's disease cases were included. Within the analyzed time period, the total number of hospital admissions increased by 10.6% (n = 23,301 vs. 26,069). While gender and age distribution remained comparable, patients with comorbidities such as stenosis formation (2010: 10.1%, 2017: 13.4%) or malnutrition (2010: 0.8%, 2017: 3.2%) were increasingly admitted. The total number of all analyzed operations for Crohn's disease increased by 7.5% (2010: n = 1567; 2017: n = 1694). On average, 6.8 ± 0.2% of all inpatient patients received ileocolonic resections. Procedures have increasingly been performed minimally invasive (2010: n = 353; 2017: n = 687). The number of postoperative complications remained low.

Conclusion

Despite the development of novel immunotherapeutics, the number of patients requiring surgery for Crohn's disease remains stable. Interestingly, patients have been increasingly hospitalized with stenosis and malnutrition. The trend towards more minimally invasive operations has not relevantly changed the rate of overall complications.

SUBMITTER: Stoss C 

PROVIDER: S-EPMC8505365 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Crohn's disease: a population-based study of surgery in the age of biological therapy.

Stöss Christian C   Berlet Maximilian M   Reischl Stefan S   Nitsche Ulrich U   Weber Marie-Christin MC   Friess Helmut H   Wilhelm Dirk D   Neumann Philipp-Alexander PA  

International journal of colorectal disease 20210419 11


<h4>Purpose</h4>Despite primary conservative therapy for Crohn's disease, a considerable proportion of patients ultimately needs to undergo surgery. Presumably, due to the increased use of biologics, the number of surgeries might have decreased. This study aimed to delineate current case numbers and trends in surgery in the era of biological therapy for Crohn's disease.<h4>Methods</h4>Nationwide standardized hospital discharge data (diagnosis-related groups statistics) from 2010 to 2017 were use  ...[more]

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