Papi et al identified clinical features associated with development of penetrating complications for a patient with Crohn's disease. The authors are from S. Filippo Neri Hospital, S. Spirito Hospital and National Institute of Health in Rome.
Outcome: development of penetrating complications not involving the perianal region
Non-perianal penetrating complications include:
(1) intra-abdominal fistula
(2) intra-abdominal mass
(3) intra-abdominal abscess
Parameters:
(1) age at initial diagnosis
(2) stricturing behavior
Parameter |
Finding |
Points |
age at diagnosis |
< 40 years |
1 |
|
>= 40 years |
0 |
stricturing behavior |
absent |
0 |
|
present |
1 |
where:
• Age < 40 at diagnosis is designated A1 in the Vienna classification.
• Stricturing disease is designated B2 in the Vienna classification.
• The odds ratio for age < 40 was 6, while for stricturing behavior was 4.
number of risk factors =
= SUM(points for the 2 parameters)
Interpretatation:
• minimum number of risk factors: 0
• maximum number of risk factors: 2
• The more risk factors present the greater the risk of intra-abdominal penetrating disease.
• Perianal penetrating disease (fistula, ulcer, abscess) was considered a distinct pattern of behavior that could not be predicted by these factors.
Specialty: Gastroenterology