Delayed Diagnosis is Associated with Early and Emergency Need for First Crohn’s Disease-Related Intestinal Surgery
Zhiwu Hong, Jianan Ren, Yuan Li, Gefei Wang, Guosheng Gu, Xiuwen Wu, Huajian Ren, Jieshou Li
Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China (mainland)
Med Sci Monit 2017; 23:4841-4846
Increasing evidence suggests that delayed diagnosis in Crohn’s disease is associated with a complicated disease course. The aim of this study was to explore the association between delayed diagnosis and the timing of the first Crohn’s disease-related intestinal surgery.
MATERIAL AND METHODS: A retrospective study included 215 Crohn’s disease patients with previous surgical history in the Department of General Surgery of Jinling Hospital, China, between January 2013 and March 2016. Data were collected on demographics, clinical characteristics, medication history, and operation history.
RESULTS: The time from the first appearance of Crohn’s disease-related symptoms to the first intestinal surgery in the delayed diagnosis group was obviously shorter than in the non-delayed diagnosis group (26.4±28.7 months vs. 42.6±58.4 months, respectively, p=0.032). Patients in the delayed diagnosis group tended to receive more ileal resections (47.8% vs. 26.4%, respectively, p=0.002) and less ileocecal resections (22.4% vs. 37.2%, respectively, p=0.032). More patients in the delayed diagnosis group received the first Crohn’s disease-related intestinal surgery as an emergency one (20.9% vs. 4.7%, respectively, p=0.001).
CONCLUSIONS: Delayed diagnosis is associated with early and emergency need for the first Crohn’s disease-related intestinal surgery.
Keywords: Crohn Disease, delayed diagnosis, general surgery, Intestines