{"title":"炎症性肠病的生物疗法、手术和住院率:拉丁美洲成人和儿童患者的观察性比较研究","authors":"Ana Carolina Veronese Silva , Tainá Júlia Tumelero , Danielle Reis Yamamoto , Sabine Kruger Truppel , Giovana Stival da Silva , Luciana Bandeira Mendez Ribeiro , Patricia Zacharias , Marcia Olandoski , Daniela Oliveira Magro , Mário César Vieira , Paulo Gustavo Kotze","doi":"10.1016/j.gastre.2024.04.040","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Compare the proportions of use of biological therapy, surgeries, and hospitalizations between adults and pediatric inflammatory bowel disease (IBD)—Crohn's disease (CD) and ulcerative colitis (UC)—patients.</div></div><div><h3>Patients and methods</h3><div>Observational, retrospective, and multicenter study. Data were collected from all consecutive IBD patients seen as outpatients or admitted to hospital, during 2015–2021, in two IBD tertiary centers in a South Brazilian capital. Patients with unclassified colitis diagnosis were excluded from this study. Patients were classified as having CD or UC and sub-categorized as adult or pediatric according to age. Data were analyzed using frequency, proportion, Fisher's exact test, and Chi-square test.</div></div><div><h3>Results</h3><div>A total of 829 patients were included: 509 with CD (378 adults/131 pediatric) and 320 with UC (225/95). Among patients with CD, no differences were observed for proportions of use of biological therapy (80.2% in pediatric vs. 73.3% in adults; <em>P</em> <!-->=<!--> <!-->0.129), surgery (46.6% vs. 50.8%; <em>P</em> <!-->=<!--> <!-->0.419), or hospitalization (64.9% vs. 56.9%; <em>P</em> <!-->=<!--> <!-->0.122). In UC, significant differences were observed for biological therapy (40.0% vs. 28.0%; <em>P</em> <!-->=<!--> <!-->0.048) and hospitalization (47.4% vs. 24.0%; <em>P</em> <!--><<!--> <!-->0.001). No significant difference was observed in surgery rates (17.9% vs. 12.4%; <em>P</em> <!-->=<!--> <!-->0.219).</div></div><div><h3>Conclusions</h3><div>Biological therapy and incidence of hospitalization were greater among pediatric patients with UC, compared with adults; no difference was observed in the need for abdominal surgery. In CD, no significant difference was observed in the three main outcomes between the age groups.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"47 8","pages":"Pages 813-820"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Biological therapy, surgery, and hospitalization rates for inflammatory bowel disease: An observational Latin American comparative study between adults and pediatric patients\",\"authors\":\"Ana Carolina Veronese Silva , Tainá Júlia Tumelero , Danielle Reis Yamamoto , Sabine Kruger Truppel , Giovana Stival da Silva , Luciana Bandeira Mendez Ribeiro , Patricia Zacharias , Marcia Olandoski , Daniela Oliveira Magro , Mário César Vieira , Paulo Gustavo Kotze\",\"doi\":\"10.1016/j.gastre.2024.04.040\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>Compare the proportions of use of biological therapy, surgeries, and hospitalizations between adults and pediatric inflammatory bowel disease (IBD)—Crohn's disease (CD) and ulcerative colitis (UC)—patients.</div></div><div><h3>Patients and methods</h3><div>Observational, retrospective, and multicenter study. Data were collected from all consecutive IBD patients seen as outpatients or admitted to hospital, during 2015–2021, in two IBD tertiary centers in a South Brazilian capital. Patients with unclassified colitis diagnosis were excluded from this study. Patients were classified as having CD or UC and sub-categorized as adult or pediatric according to age. Data were analyzed using frequency, proportion, Fisher's exact test, and Chi-square test.</div></div><div><h3>Results</h3><div>A total of 829 patients were included: 509 with CD (378 adults/131 pediatric) and 320 with UC (225/95). Among patients with CD, no differences were observed for proportions of use of biological therapy (80.2% in pediatric vs. 73.3% in adults; <em>P</em> <!-->=<!--> <!-->0.129), surgery (46.6% vs. 50.8%; <em>P</em> <!-->=<!--> <!-->0.419), or hospitalization (64.9% vs. 56.9%; <em>P</em> <!-->=<!--> <!-->0.122). In UC, significant differences were observed for biological therapy (40.0% vs. 28.0%; <em>P</em> <!-->=<!--> <!-->0.048) and hospitalization (47.4% vs. 24.0%; <em>P</em> <!--><<!--> <!-->0.001). No significant difference was observed in surgery rates (17.9% vs. 12.4%; <em>P</em> <!-->=<!--> <!-->0.219).</div></div><div><h3>Conclusions</h3><div>Biological therapy and incidence of hospitalization were greater among pediatric patients with UC, compared with adults; no difference was observed in the need for abdominal surgery. In CD, no significant difference was observed in the three main outcomes between the age groups.</div></div>\",\"PeriodicalId\":100569,\"journal\":{\"name\":\"Gastroenterología y Hepatología (English Edition)\",\"volume\":\"47 8\",\"pages\":\"Pages 813-820\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterología y Hepatología (English Edition)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2444382424001123\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterología y Hepatología (English Edition)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2444382424001123","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的比较成人和儿童炎症性肠病(IBD)--克罗恩病(CD)和溃疡性结肠炎(UC)--患者使用生物疗法、手术和住院治疗的比例。患者和方法观察性、回顾性和多中心研究。研究收集了巴西南部首府两家 IBD 三级医疗中心在 2015-2021 年期间门诊或住院的所有连续 IBD 患者的数据。本研究排除了诊断为未分类结肠炎的患者。患者被分为 CD 或 UC,并根据年龄分为成人和儿童。数据采用频率、比例、费雪精确检验和卡方检验进行分析:共纳入 829 名患者:509 名 CD 患者(378 名成人/131 名儿童)和 320 名 UC 患者(225 名/95 名)。在 CD 患者中,使用生物疗法(儿科 80.2% 对成人 73.3%;P = 0.129)、手术(46.6% 对 50.8%;P = 0.419)或住院(64.9% 对 56.9%;P = 0.122)的比例没有差异。在 UC 中,生物疗法(40.0% vs. 28.0%;P = 0.048)和住院治疗(47.4% vs. 24.0%;P < 0.001)有明显差异。结论与成人相比,儿童 UC 患者接受生物治疗和住院治疗的比例更高;在腹部手术需求方面未观察到差异。CD患者的三个主要结果在年龄组之间无明显差异。
Biological therapy, surgery, and hospitalization rates for inflammatory bowel disease: An observational Latin American comparative study between adults and pediatric patients
Objective
Compare the proportions of use of biological therapy, surgeries, and hospitalizations between adults and pediatric inflammatory bowel disease (IBD)—Crohn's disease (CD) and ulcerative colitis (UC)—patients.
Patients and methods
Observational, retrospective, and multicenter study. Data were collected from all consecutive IBD patients seen as outpatients or admitted to hospital, during 2015–2021, in two IBD tertiary centers in a South Brazilian capital. Patients with unclassified colitis diagnosis were excluded from this study. Patients were classified as having CD or UC and sub-categorized as adult or pediatric according to age. Data were analyzed using frequency, proportion, Fisher's exact test, and Chi-square test.
Results
A total of 829 patients were included: 509 with CD (378 adults/131 pediatric) and 320 with UC (225/95). Among patients with CD, no differences were observed for proportions of use of biological therapy (80.2% in pediatric vs. 73.3% in adults; P = 0.129), surgery (46.6% vs. 50.8%; P = 0.419), or hospitalization (64.9% vs. 56.9%; P = 0.122). In UC, significant differences were observed for biological therapy (40.0% vs. 28.0%; P = 0.048) and hospitalization (47.4% vs. 24.0%; P < 0.001). No significant difference was observed in surgery rates (17.9% vs. 12.4%; P = 0.219).
Conclusions
Biological therapy and incidence of hospitalization were greater among pediatric patients with UC, compared with adults; no difference was observed in the need for abdominal surgery. In CD, no significant difference was observed in the three main outcomes between the age groups.