Related Experiment Video
Updated: May 5, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Risk factors for relapse and surgery rate in children with Crohn's disease
Iva Hojsak1, Ana Močić Pavić, Zrinjka Mišak
1Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, School of Medicine, University of Zagreb, Klaićeva 16, Zagreb, Croatia, ivahojsak@gmail.com.
Insights
Exclusive enteral nutrition (EEN) effectively induces remission and may prevent first-year relapses in pediatric Crohn's disease (CD). Early EEN is crucial for managing pediatric CD, showing significant benefits in remission and relapse prevention.
Area of Science:
- Pediatric gastroenterology
- Inflammatory bowel disease research
- Clinical trial analysis
Background:
- Crohn's disease (CD) poses significant challenges in pediatric populations.
- Understanding risk factors for relapse and surgery is crucial for effective management.
- Current treatment strategies require further evaluation for long-term efficacy.
Purpose of the Study:
- To identify risk factors for first-year relapse and subsequent surgery in children with CD.
- To evaluate the efficacy of exclusive enteral nutrition (EEN) as an induction therapy.
- To assess the impact of clinical variables at diagnosis on disease course.
Main Methods:
- Retrospective analysis of 74 pediatric CD patients diagnosed between 2004 and 2011.
- Multivariate Cox proportional hazards regression model utilized.
- Key clinical variables assessed: age, perianal disease, induction/maintenance therapy, PCDAI, CRP, and SDS.
Main Results:
- 48.6% of patients experienced relapse within the first year.
- Exclusive enteral nutrition (EEN) as induction therapy significantly reduced relapse risk (HR 0.469).
- EEN achieved remission in 84.2% of patients; upper GI tract involvement was linked to EEN failure.
Conclusions:
- Early use of EEN is vital for pediatric CD treatment.
- EEN is effective for remission induction and may prevent early relapses.
- No significant surgical risk factors were identified in this cohort.
Unlabelled:
The aim of this study was to evaluate risk factors associated with the relapse rate in the first year and the need for surgery in children with Crohn's disease (CD). Data of all children (n = 74) diagnosed with CD from January 2004 to June 2011 were retrospectively analyzed. Multivariate Cox proportional hazards regression model was used to assess whether important clinical variables at diagnosis (age, presence of perianal disease, first induction therapy, first maintenance therapy, levels of Pediatric CD Activity Index (PCDAI), C-reactive protein (CRP), and standard deviation score (SDS) for height for weight) were associated with the risk of clinical recurrence in the first year and need for surgery during follow-up. Relapse occurred in 36 (48.6 %) patients in the first year from diagnosis. The only significant parameter associated with negative risk of relapse in the first year was exclusive enteral nutrition (EEN) used as induction therapy (hazard ratio (HR) 0.469, 95 % confidence interval (CI) 0.232-0.948). EEN induced remission in 84.2 % of patients. The only risk associated with EEN treatment failure was the involvement of the upper gastrointestinal tract. During the follow-up, 25 (33.7 %) patients underwent surgery. The multivariate Cox regression model failed to recognize significant risk factor for surgery.
Conclusion:
This study underlines the importance of early EEN in the treatment of CD; it is not only efficacious in the remission induction but could also prevent relapse in the first year.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...