Clinical outcomes and long-term prognosis of perianal Crohn's disease in an Asian population

Abstract

Background and Aim: The clinical impact of perianal Crohn’s disease (CD) (pCD), a wellknown poor prognostic factor of CD, has not been fully evaluated in Asian patients. We investigated the outcomes of CD in Korean patients according to the presence of pCD at CD diagnosis. Methods: Using 2010?2014 data from the national health insurance claims database, we evaluated the disease course of CD according to the presence of pCD at CD diagnosis. The results were veried in a hospitalbased cohort of 2923 patients. Results: The cumulative risk of intestinal resection was lower in patients with pCD at di- agnosis than in those without, in the populationbased cohort (9.1% vs 14.7% at 5 years after diagnosis, P < 0.001), but it was similar between the two groups in the hospitalbased cohort (36.8% vs 36.8% at 10 years after diagnosis, P = 0.950). Moreover, the cumulative risk of behavioral progression was not signicantly different between the two groups in the hospitalbased cohort (43.4% vs 41.6% at 10 years after diagnosis, P = 0.366). On multivariable analysis, pCD at CD diagnosis was not a predictor of intesti- nal resection, behavioral progression, CDrelated hospital admission, or diverting surgery; however, it was an independent predictor of proctectomy (hazard ratio [HR] 3.210, P < 0.001) and anorectal cancer (HR 3.104, P = 0.047). Conclusions: Although the presence of pCD increased the risk of proctectomy and anorectal cancer in Asian patients, the clinical impact of pCD on the overall outcomes of patients with CD may be less signicant in Asian patients compared with Western patients.