Crohn's disease: relapse and surgery were common.

Clinical bottom line (level 4)

  1. Almost all patients with Crohn's disease relapsed within 10 years.
  2. Around half required surgery.
  3. Cancer was very rare (< 1%).
Binder et al: Gut 1985; 26: 146-150
Expires May 2003

The study

Case series with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: university hospital, Denmark. 1960 to 1978

185 patients (aged range 4 to 76 years; mean 33, 60% female) Crohn's disease


100% followed for 1 to 18 years; median 5.5
Outcomes studied:
  • surgery at 5.5 years
  • relapse at 10 years
  • cancer at 9.8 years

The evidence

outcome time to outcome number of patients/total number %
(95% CI)
surgery at 5.5 years 1 to 18 years; median 5.5 102/185 55%
(48% to 62%)
relapse at 10 years 1 to 18 years; median 5.5 183/185 99%
(97% to 100%)
cancer at 9.8 years 1 to 18 years; median 5.5 1/185 0.5%
(0.0% to 1.6%)

  • No increase in death rate was seen compared with the general population.
  • A third of all patients had surgery within the first year of diagnosis. 13% had more than one operation.

Citation

  1. Binder V, Hendriksen C, Kreiner S: Prognosis in Crohn's disease - based on results from a regional patient group from the county of Copenhagen. Gut 1985; 26: 146-150
Contributor: Chris Ball and Clare Wotton, October 2000
Reviewer:

Clinical Question.
Patient Crohn's disease
Intervention or Exposure prevalence
Outcome relapse, surgery, cancer