Risk factors for stricture-related surgery in stricturing Crohn's disease.

Area of Science:

• Gastroenterology
• Inflammatory Bowel Disease
• Surgical Outcomes

Background:

• Crohn's disease (CD) is a chronic gastrointestinal inflammatory condition.
• Strictures complicate CD in nearly 50% of patients, often requiring intervention.
• Identifying surgical risk factors and complications in CD strictures is crucial.

Purpose of the Study:

• To identify surgical risk factors in Crohn's disease patients with strictures.
• To assess postoperative complications in these patients.
• To understand predictors of surgical necessity in CD strictures.

Main Methods:

• Retrospective analysis of 128 patients with stricturing CD from 1989-2024.
• Data collected from IBD outpatient clinic records.
• Risk factors for surgery and 90-day postoperative complications were assessed.

Main Results:

• Prior biologic therapy (87.5% vs 36.4%) and ileocolonic involvement were linked to higher surgical rates.
• Independent predictors for surgery included longer disease duration (OR=1.112) and biologic use (OR=2.749).
• Postoperative complications occurred in 36.1% of surgical patients, with no identified significant risk factors.

Conclusions:

• Longer disease duration and prior biologic therapy independently predict increased surgical risk in CD strictures.
• These factors likely reflect more severe disease phenotypes.
• Extended disease duration may drive stricture development and surgical need in aggressive CD.