[Reclassification of the diagnosis in inflammatory bowel disease based on a retrospective analysis].

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2026-08-18 DOI:10.26442/00403660.2026.08.203724

I G Bakulin, Y A Akishina

{"title":"[Reclassification of the diagnosis in inflammatory bowel disease based on a retrospective analysis].","authors":"I G Bakulin, Y A Akishina","doi":"10.26442/00403660.2026.08.203724","DOIUrl":null,"url":null,"abstract":"Aim: To assess the cumulative frequency and patterns of diagnostic reclassification in inflammatory bowel disease (IBD).Materials and methods: A single-center retrospective longitudinal cohort study was conducted at the Department of Gastroenterology, Peter the Great Clinic, Mechnikov North-Western State Medical University. The study included 800 patients with an established diagnosis of IBD. Grounds for diagnostic reclassification were analyzed. The primary endpoint was the cumulative frequency of diagnostic reclassification. Secondary endpoints included patterns of reclassification in patients initially diagnosed with unclassified IBD and ulcerative colitis (UC), median time to diagnostic revision, the clinical and morphological grounds for reclassification.Results: During follow-up, diagnostic reclassification occurred in 17.6% of cases (n=141). Among reclassified patients, the initial diagnosis was IBDU in 16.3% (n=23) and UC in 83.7% (n=118). In 93.6% of cases (n=132), reclassification resulted in Crohn's disease (CD) (95% CI 88.2-97.0); in 9 patients, the final diagnosis was unknown due to missing data. The median time from the initial diagnosis to reclassification was 42.0 months [16.0; 99.0]. The most common reason for diagnostic revision was the identification of segmental involvement: 50.0% (7/14) among patients initially classified as IBDU and 63.6% (75/118) among those initially diagnosed with UC (p=0.386). In the presence of a stricture, the median time to reclassification was 96 months [37.0; 186.0].Conclusion: Diagnostic reclassification in patients with IBD is a prolonged and clinically meaningful process. The findings support the possibility of diagnostic reassessment in patients initially diagnosed with UC or IBDU. In clinical practice, when establishing an IBD diagnosis - particularly UC - it is important to consider the potential for reclassification, and when indications for revision are present, to document the fact of reclassification.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 8","pages":"446-450"},"PeriodicalIF":0.3000,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Terapevticheskii Arkhiv","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.26442/00403660.2026.08.203724","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Aim: To assess the cumulative frequency and patterns of diagnostic reclassification in inflammatory bowel disease (IBD).

Materials and methods: A single-center retrospective longitudinal cohort study was conducted at the Department of Gastroenterology, Peter the Great Clinic, Mechnikov North-Western State Medical University. The study included 800 patients with an established diagnosis of IBD. Grounds for diagnostic reclassification were analyzed. The primary endpoint was the cumulative frequency of diagnostic reclassification. Secondary endpoints included patterns of reclassification in patients initially diagnosed with unclassified IBD and ulcerative colitis (UC), median time to diagnostic revision, the clinical and morphological grounds for reclassification.

Results: During follow-up, diagnostic reclassification occurred in 17.6% of cases (n=141). Among reclassified patients, the initial diagnosis was IBDU in 16.3% (n=23) and UC in 83.7% (n=118). In 93.6% of cases (n=132), reclassification resulted in Crohn's disease (CD) (95% CI 88.2-97.0); in 9 patients, the final diagnosis was unknown due to missing data. The median time from the initial diagnosis to reclassification was 42.0 months [16.0; 99.0]. The most common reason for diagnostic revision was the identification of segmental involvement: 50.0% (7/14) among patients initially classified as IBDU and 63.6% (75/118) among those initially diagnosed with UC (p=0.386). In the presence of a stricture, the median time to reclassification was 96 months [37.0; 186.0].

Conclusion: Diagnostic reclassification in patients with IBD is a prolonged and clinically meaningful process. The findings support the possibility of diagnostic reassessment in patients initially diagnosed with UC or IBDU. In clinical practice, when establishing an IBD diagnosis - particularly UC - it is important to consider the potential for reclassification, and when indications for revision are present, to document the fact of reclassification.

查看原文本刊更多论文

[基于回顾性分析的炎症性肠病诊断重新分类]。

目的：评估炎症性肠病（IBD）诊断重分类的累积频率和模式。材料和方法：在梅奇尼科夫西北国立医科大学彼得大诊所消化内科进行了一项单中心回顾性纵向队列研究。该研究包括800名确诊为IBD的患者。分析了诊断重分类的依据。主要终点是诊断再分类的累积频率。次要终点包括最初诊断为未分类IBD和溃疡性结肠炎（UC）的患者的重新分类模式，到诊断修订的中位时间，重新分类的临床和形态学依据。结果：随访期间，17.6%的病例（n=141）出现诊断重分。在重新分类的患者中，首次诊断为IBDU的占16.3% (n=23)， UC的占83.7% （n=118）。在93.6%的病例（n=132）中，重新分类导致克罗恩病（CD）（95% CI 88.2-97.0）；9例患者因资料缺失，最终诊断未知。从初次诊断到重新分类的中位时间为42.0个月[16.0；99.0]。诊断修改最常见的原因是确定节段受累：最初诊断为IBDU的患者中有50.0%(7/14)，最初诊断为UC的患者中有63.6% (75/118)（p=0.386）。存在狭窄时，重新分类的中位时间为96个月[37.0；186.0]。结论：IBD患者的诊断再分类是一个长期且有临床意义的过程。研究结果支持对最初诊断为UC或IBDU的患者进行重新诊断的可能性。在临床实践中，当确定IBD诊断时，特别是UC诊断时，考虑重新分类的可能性是很重要的，当有重新分类的指征时，记录重新分类的事实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.