Yang et al identified factors predictive of postoperative recurrence after a primary bowel resection for Crohn's disease. This can help to identify a patient who may benefit from more aggressive management. The authors are from Asan Medical Center in Seoul, Korea.
Patient selection: status post primary bowel resection for Crohn's disease
Number of Years After First Resection
Second Resection
Clinical Recurrence
1 years
1.1%
1.2%
5 years
8.3%
23.6%
10 years
35.9%
68.1%
Predictors for recurrence:
(1) primary resection performed as an emergency procedure (HR 2.43)
(2) cigarette smoking (HR 1.80)
(3) presence of perianal disease after the first operation (HR 1.72)
(4) therapy with anti-TNF targeted therapy (HR 0.52)
cumulative product of the hazard ratios =
= PRODUCT(all 4 hazard ratios)
Interpretation:
• minimum cumulative hazard ratio: 0.52
• maximum cumulative hazard ratio: 7.52
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