Prevalence and predictors of severe Crohn’s disease at a tertiary hospital in South Africa
Background Predicting severe Crohn's disease (SCD) can assist in planning risk reduction therapy for SCD, thereby improving disease outcomes. Objective To determine the prevalence and predictors of SCD in a sample of South African patients. Methods This was a retrospective chart revi...
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South African Medical Association
2024-04-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1667 |
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| author | C Gounden V Naidoo Y Moodley |
| author_facet | C Gounden V Naidoo Y Moodley |
| author_sort | C Gounden |
| collection | DOAJ |
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Background
Predicting severe Crohn's disease (SCD) can assist in planning risk reduction therapy for SCD, thereby improving disease outcomes.
Objective
To determine the prevalence and predictors of SCD in a sample of South African patients.
Methods
This was a retrospective chart review of patients with Crohn's disease (CD) attending the Gastroenterology Unit at a tertiary hospital in Durban, South Africa. Demographic and clinical variables at diagnosis of CD were collected and analysed for statistical association with development of SCD (defined as the presence of >/= 1 of the following over the course of CD: complex perianal disease, colonic resection >/= 2 small bowel resections, a single small bowel resection > 50cm, or construction of a definitive stoma). The prognostic utility of statistically significant variables was investigated by establishing their sensitivity, specificity, and predictive values for SCD.
Results
The study consisted of 93 patients. The rate of SCD was 64.5%, with 63.3 % of patients developing SCD within 1 year of CD diagnosis. Ileocolonic location (p = 0.046) and penetrating disease at initial diagnosis of CD (p = 0.021) were statistically associated with SCD. The sensitivity, specificity, positive predictive value, and negative predictive value of ileocolonic location for SCD was 72.7%, 47.4%, 66.7% and 54.6%. The sensitivity, specificity, positive predictive value, and negative predictive value of penetrating disease for SCD was 85.7%, 41.7%, 30.0% and 91.0%.
Conclusion
Most patients with CD developed SCD within 1 year of their CD diagnosis. CD with a penetrating phenotype at diagnosis is a good predictor for the devleopment of SCD and should be further investigated.
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| format | Article |
| id | doaj-art-3f5b44acd3364ce19f3365df797b86b4 |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-3f5b44acd3364ce19f3365df797b86b42025-02-10T12:26:18ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-04-01114410.7196/SAMJ.2024.v114i4.1667Prevalence and predictors of severe Crohn’s disease at a tertiary hospital in South AfricaC Gounden0V Naidoo1Y Moodley2Department of Gastroenterology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; Gastrointestinal Cancer Research Group, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South AfricaDepartment of Gastroenterology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; Gastrointestinal Cancer Research Group, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South AfricaDivision of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Gastrointestinal Cancer Research Group, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa Background Predicting severe Crohn's disease (SCD) can assist in planning risk reduction therapy for SCD, thereby improving disease outcomes. Objective To determine the prevalence and predictors of SCD in a sample of South African patients. Methods This was a retrospective chart review of patients with Crohn's disease (CD) attending the Gastroenterology Unit at a tertiary hospital in Durban, South Africa. Demographic and clinical variables at diagnosis of CD were collected and analysed for statistical association with development of SCD (defined as the presence of >/= 1 of the following over the course of CD: complex perianal disease, colonic resection >/= 2 small bowel resections, a single small bowel resection > 50cm, or construction of a definitive stoma). The prognostic utility of statistically significant variables was investigated by establishing their sensitivity, specificity, and predictive values for SCD. Results The study consisted of 93 patients. The rate of SCD was 64.5%, with 63.3 % of patients developing SCD within 1 year of CD diagnosis. Ileocolonic location (p = 0.046) and penetrating disease at initial diagnosis of CD (p = 0.021) were statistically associated with SCD. The sensitivity, specificity, positive predictive value, and negative predictive value of ileocolonic location for SCD was 72.7%, 47.4%, 66.7% and 54.6%. The sensitivity, specificity, positive predictive value, and negative predictive value of penetrating disease for SCD was 85.7%, 41.7%, 30.0% and 91.0%. Conclusion Most patients with CD developed SCD within 1 year of their CD diagnosis. CD with a penetrating phenotype at diagnosis is a good predictor for the devleopment of SCD and should be further investigated. https://samajournals.co.za/index.php/samj/article/view/1667Severe Crohn’s disease, prevalence, predictors, ileocecal location, penetrating disease |
| spellingShingle | C Gounden V Naidoo Y Moodley Prevalence and predictors of severe Crohn’s disease at a tertiary hospital in South Africa South African Medical Journal Severe Crohn’s disease, prevalence, predictors, ileocecal location, penetrating disease |
| title | Prevalence and predictors of severe Crohn’s disease at a tertiary hospital in South Africa |
| title_full | Prevalence and predictors of severe Crohn’s disease at a tertiary hospital in South Africa |
| title_fullStr | Prevalence and predictors of severe Crohn’s disease at a tertiary hospital in South Africa |
| title_full_unstemmed | Prevalence and predictors of severe Crohn’s disease at a tertiary hospital in South Africa |
| title_short | Prevalence and predictors of severe Crohn’s disease at a tertiary hospital in South Africa |
| title_sort | prevalence and predictors of severe crohn s disease at a tertiary hospital in south africa |
| topic | Severe Crohn’s disease, prevalence, predictors, ileocecal location, penetrating disease |
| url | https://samajournals.co.za/index.php/samj/article/view/1667 |
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