Evidence map›Paper›PMID 33127595›Full record

SynthesisClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2021

Contemporary Risk of Surgery in Patients With Ulcerative Colitis and Crohn's Disease: A Meta-Analysis of Population-Based Cohorts.

Lester Tsai, Christopher Ma, Parambir S Dulai, Larry J Prokop, Samuel Eisenstein, Sonia L Ramamoorthy, Brian G Feagan, Vipul Jairath, William J Sandborn, Siddharth Singh

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06312683 (Rifaximin for the Secondary Prevention of Recurrent Pouchitis), which is not on this map. Cited by 169 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
169citing papers in PubMed, 16 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06312683 phase4recruitingnot on this mapstarted 2024, after this paper: background citation

Rifaximin for the Secondary Prevention of Recurrent Pouchitis

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2024 to 2027Enrolled16ConditionsPouchitisArmsRifaximin 550 MG Oral Tablet [XIFAXAN]
3 · Its place in the literature

Who cites it

169 citing papers in PubMed, 16 syntheses or guidelines pooled it.

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  4. A systematic review of the methodological quality of randomised trials in IBD surgery.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026
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  8. Diagnostic Accuracy of Noninvasive Biomarkers and Imaging for Evaluating Postoperative Recurrence in Crohn's Disease.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025
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109 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Lester TsaiDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California.
Christopher MaDivision of Gastroenterology, University of Calgary, Calgary, Alberta, Canada.
Parambir S DulaiDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California.
Larry J ProkopKnowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota.
Samuel EisensteinDivision of Colorectal Surgery, Department of Surgery, University of California San Diego, La Jolla, California.
Sonia L RamamoorthyDivision of Colorectal Surgery, Department of Surgery, University of California San Diego, La Jolla, California.
Brian G FeaganDivision of Gastroenterology, University of Western Ontario, London, Ontario, Canada.
Vipul JairathDivision of Gastroenterology, University of Western Ontario, London, Ontario, Canada.
William J SandbornDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California.
Siddharth SinghDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California. Electronic address: sis040@ucsd.edu.

Funding

San Diego Digestive Diseases Research CenterP30DK120515 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Tatiana Kisseleva · 2019 to 2026
$10.8M
Comparative Risks and Benefits of Pharmacological Therapies for Older Patients with Inflammatory Bowel DiseasesK23DK117058 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SINGH, SIDDHARTH · 2018 to 2022
$971k
NIDDK NIH HHS K23 DK117058NIDDK NIH HHS P30 DK120515
6 · The paper itself

Abstract

BACKGROUND &

aimsWe conducted a systematic review with meta-analysis to estimate rates and trends of colectomy in patients with ulcerative colitis (UC), and of primary and re-resection in patients with Crohn's disease (CD), focusing on contemporary risks.

methodsThrough a systematic review until September 3, 2019, we identified population-based cohort studies that reported patient-level cumulative risk of surgery in patients with UC and CD. We evaluated overall and contemporary risk (after 2000) of surgery and analyzed time trends through mixed-effects meta-regression.

resultsIn patients with UC (26 studies), the overall 1-, 5-, and 10-year risks of colectomy was 4.0% (95% CI, 3.3-5.0), 8.8% (95% CI, 7.7-10.0), and 13.3% (95% CI, 11.3-15.5), respectively, with a decrease in risk over time (P < .001). Corresponding contemporary risks were 2.8% (95% CI, 2.0-3.9), 7.0% (95% CI, 5.7-8.6), and 9.6% (95% CI, 6.3-14.2), respectively. In patients with CD (22 studies), the overall 1-, 5-, and 10-year risk of surgery was 18.7% (95% CI, 15.0-23.0), 28.0% (95% CI, 24.0-32.4), and 39.5% (95% CI, 33.3-46.2), respectively, with a decrease in risk over time (P < .001). Corresponding contemporary risks were 12.3% (95% CI, 10.8-14.0), 18.0% (95% CI, 15.4-21.0), and 26.2% (95% CI, 23.4-29.4), respectively. In a meta-analysis of 8 studies in patients with CD with prior resection, the cumulative risk of a second resection at 5 and 10 years after the first resection was 17.7% (95% CI, 13.5-22.9) and 31.3% (95% CI, 24.1-39.6), respectively.

conclusionsPatient-level risks of surgery have decreased significantly over time, with a 5-year cumulative risk of surgery of 7.0% in UC and 18.0% in CD in contemporary cohorts. This decrease may be related to early detection and/or better treatment.

Indexed as

Colitis, UlcerativeCrohn DiseaseCohort StudiesColectomyHumansDisease ModificationInflammatory Bowel DiseasesNatural HistoryResectionTumor Necrosis Factor

Identifiers

PMID33127595
PMCPMC8934200

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.