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https://hdl.handle.net/2440/60026
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DC Field | Value | Language |
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dc.contributor.author | Van Langenberg, D. | - |
dc.contributor.author | Lange, K. | - |
dc.contributor.author | Hetzel, D. | - |
dc.contributor.author | Holtmann, G. | - |
dc.contributor.author | Andrews, J. | - |
dc.date.issued | 2010 | - |
dc.identifier.citation | Journal of Gastroenterology and Hepatology, 2010; 25(7):1250-1258 | - |
dc.identifier.issn | 0815-9319 | - |
dc.identifier.issn | 1440-1746 | - |
dc.identifier.uri | http://hdl.handle.net/2440/60026 | - |
dc.description.abstract | Background and Aim: A significant proportion with inflammatory bowel disease (IBD) exhibit an adverse clinical phenotype reflected in endpoints like surgery and hospitalizations. We sought to identify clinico-demographic factors associated with these adverse consequences that may be amenable to change. Methods: Over 6 months IBD patients visiting a metropolitan center were prospectively identified and given a comprehensive survey addressing patient knowledge, mental health and satisfaction with medical care along with other clinical data. Logistic regression analyses assessed for associations between clinico-demographic variables and adverse clinical endpoints (previous surgery [ever] and/or recent inpatient admission over a 16 month observation period). Results: Of 256 IBD patients, 162 responded (response rate 63%); 95 (59%) had Crohn's disease (CD), 63 (40%) ulcerative colitis (UC), four indeterminate colitis; 53% were female. Factors associated with a greater likelihood of hospitalization included moderate/severe disease activity, psychological co-morbidity, numbers of medications and outpatient visits (odds ratio [OR] 7.09 [2.83–17.76], 4.13 [1.25–13.61], 1.26 [1.03–1.54], 1.17 [1.00–1.37] respectively; all P < 0.05). Post-surgical patients were more likely to have CD, more currently active disease and longer disease duration (OR 8.55 [2.43–29.4], 3.52 [1.26, 9.87], 1.14 [1.08, 1.21] respectively; all P < 0.02), yet were less likely to have previously seen a gastroenterologist, OR 0.25 [0.08–0.76] (P = 0.01). Conclusions: ‘At risk’ patients (those previously operated, with ongoing disease activity, dissatisfaction and/or psychological comorbidities) may benefit from early identification and more intensive management. Specialist gastroenterology care appears to be under-utilized in operated patients yet may reduce future IBD morbidity. | - |
dc.description.statementofresponsibility | Daniel R. Van Langenberg, Kylie Lange, David J. Hetzel, Gerald J. Holtmann and Jane M. Andrews | - |
dc.language.iso | en | - |
dc.publisher | Blackwell Publishing Asia | - |
dc.rights | © 2010 The Authors. Journal compilation © 2010 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd. | - |
dc.source.uri | http://dx.doi.org/10.1111/j.1440-1746.2010.06302.x | - |
dc.subject | bowel surgery | - |
dc.subject | gastroenterologist | - |
dc.subject | hospitalization | - |
dc.subject | inflammatory bowel disease | - |
dc.subject | psychological comorbidity | - |
dc.subject | quality of care | - |
dc.title | Adverse clinical phenotype in inflammatory bowel disease: A cross sectional study identifying factors potentially amenable to change | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1111/j.1440-1746.2010.06302.x | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Lange, K. [0000-0003-3814-8513] | - |
dc.identifier.orcid | Andrews, J. [0000-0001-7960-2650] | - |
Appears in Collections: | Aurora harvest Medicine publications |
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