ArticleJournal of Crohn's & colitis2020
Causes and Prognosis of Intestinal Failure in Crohn's Disease: An 18-year Experience From a National Centre.
Article in Journal of Crohn's & colitis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 17 citations in OpenAlex.
- Improved Outcomes Associated With Teduglutide Use in Patients With Both Short Bowel Syndrome and Crohn's Disease.Crohn's & colitis 360 · 2024Article
- Clinical challenges of short bowel syndrome and the path forward for organoid-based regenerative medicine.Regenerative therapy · 2023Review
- Surgical Planning in Penetrating Abdominal Crohn's Disease.Frontiers in surgery · 2022Review
- Editorial: Abdominal and Perianal Fistulizing Crohn's Disease: Imaging, Surgical Techniques and Basic Research.Frontiers in surgery · 2022Article
- Chronic intestinal failure and short bowel syndrome in Crohn's disease.World journal of gastroenterology · 2021Review
- Managing intestinal failure in inflammatory bowel disease - 'when the drugs don't work'.Frontline gastroenterology · 2021Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsIntestinal failure [IF] is a feared complication of Crohn's disease [CD]. Although cumulative loss of small bowel due to bowel resections is thought to be the dominant cause, the causes and outcomes have not been reported.
methodsConsecutive adult patients referred to a national intestinal failure unit over 2000-2018 with a diagnosis of CD, and subsequently treated with parenteral nutrition during at least 12 months, were included in this longitudinal cohort study. Data were extracted from a prospective institutional clinical database and patient records.
resultsA total of 121 patients were included. Of these, 62 [51%] of patients developed IF as a consequence of abdominal sepsis complicating abdominal surgery; small bowel resection, primary disease activity, and proximal stoma were less common causes [31%, 12%, and 6%, respectively]. Further, 32 had perianastomotic sepsis, and 15 of those had documented risk factors for anastomotic dehiscence. On Kaplan-Meier analysis, 40% of all patients regained nutritional autonomy within 10 years and none did subsequently; 14% of patients developed intestinal failure-associated liver disease. On Kaplan-Meier analysis, projected mean age of death was 74 years.2.
conclusionsIF is a severe complication of CD, with 60% of patients permanently dependent on parenteral nutrition. The most frequent event leading directly to IF was a septic complication following abdominal surgery, in many cases following intestinal anastomosis in the presence of significant risk factors for anastomotic dehiscence. A reduced need for abdominal surgery, an increased awareness of perioperative risk factors, and structured pre-operative optimisation may reduce the incidence of IF in CD.
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