S1065 Predictors of Endoscopic Response and Remission in Patients with Active Crohn's Disease Treated with Certolizumab Pegol: A Logistic Regression Analysis of the Music Data

2009 ◽  
Vol 136 (5) ◽  
pp. A-181
Author(s):  
Jean-Frederic Colombel ◽  
Marc Lemann ◽  
Matthieu Allez ◽  
Krassimir Mitchev ◽  
Corinne Jamoul ◽  
...  
2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S258-S259
Author(s):  
R A Gonzalez ◽  
E J Gómez ◽  
L Pereyra ◽  
J M Mella ◽  
G N Panigadi ◽  
...  

Abstract Background Capsule endoscopy (CE) can detect small bowel (SB) lesions compatible of Crohn’s disease (CD) in patients with suggestive symptoms but with inconclusive results for the diagnostic workup. However, the clinical impact of CE in helping physicians to make decisions about patients with suspected CD is not currently well established. The aim of the study was to investigate the clinical impact of CE to confirm diagnosis of CD and also to evaluate whether the results of CE modify therapeutic decisions. Methods We conducted a single-centre retrospective cohort study. All consecutive adult’s patients submitted to CE for clinical suspected of CD, on period November 2012 to November 2018, were included. Data on demography, previous research, medications for IBD, CE procedures and follow-up were analysed. Multivariate logistic regression analysis was carried out to identify predictors of CD. Results A total of 329 CE protocols in adult’s patients were performed over the study period. Ninety were in IBD patients and were included in the analysis 63 CEs submitted for suspected of CD: Clinical suspected CD 54(86%) and colitis unclassified 9 (14%). The mean age was 41 years (range 17–77 years) and 54% were males. The CE reached the caecum in 58 cases (92%) and retention was observed in 5 (8%) with only one patient (1.6%) requiring surgical removal. Overall, 28 of 63 patients (44%) had CE findings consistent with the diagnosis of CD. The lesions identified by CE included ulcers 24 (86%), erythema and villous oedema 17(61%), aphthas and mucosal erosions 5 (18%), stenosis 2 (7%) and were distributed mainly in the distal part of the SB (third tertile) in 23 (82%), but in 14 (50%) cases the proximal SB (first and second tertiles) was also affected. The mean Lewis Score (LS) was 903 (112–4356). Significant inflammatory activity (LS ≥ 135) was detected in 17 (27%) and was moderate or severe (LS > 790) in 7 (11%). CE visualise normal SB mucosa in 34 (54%) of patient’s, which rules out CD. Therapeutic started in 23 (36%) of patients, initiating a new IBD medication in most cases in the 3 months after the CE. On logistic regression analysis, male (p = 0.02) and findings in ileocolonoscopy (p = 0.004) were independents predictors of CD. Conclusion In our cohort, CE in suspected CD confirm diagnosis in 44% of cases. Male gender and findings in ileocolonoscopy appear to be independents predictors of CD. CE is a useful tool in suspected CD, since it adds relevant information for diagnosis and had a great impact on therapeutic decisions.


2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 99-100
Author(s):  
J Stone ◽  
K Witges ◽  
L Shafer ◽  
L E Targownik ◽  
L M Lix ◽  
...  

Abstract Background Medication non-adherence in IBD has previously been reported to be quite variable, ranging from 7 to 73%, and is considered to be an important contributor to disease flares. While there is currently no gold standard for medication adherence reporting in IBD, the Medication Adherence Reporting Scale 5 (MARS-5) has frequently been used in this population, but never validated. Aims This study aimed to analyze medication adherence rates in a cohort of persons with IBD in Manitoba, report predictors of medication non-adherence on self-reported symptoms, and validate the MARS-5 as a medication adherence tool. Methods 55 subjects were prospectively followed with biweekly online surveys in the Manitoba Living with IBD Study. Subjects not taking any medications for IBD or only taking as needed, missing adherence data and those lost to follow-up were excluded, leaving 112 subjects. Descriptive data on demographics, surgeries, IBD medications, medication adherence, and measures of disease activity utilizing IBDSI-SF scores were collected. Mean annual medication adherence percentage, IBDSI-SF(>14=active for Crohn’s,>13=active for UC) and MARS-5 scores were calculated. Logistic regression analysis was performed to determine variables associated with medication adherence and to validate the MARS-5. Results Mean age was 42.9 years (SD 12.8), with 71.4% being female. Crohn’s disease (CD) was diagnosed in 67.9%, with 37.5% having undergone at least one abdominal surgery. 70.5% of patients were on 2 or more IBD medications. Mean IBDSI score was 15.5 and mean MARS-5 score was 22.5. 20 (17.9%) patients reported a mean adherence of <90% across all medications- 18 were oral medication users, 1 was on an infusion biologic and 1 on subcutaneous adalimumab. 10 (9.8%) had adherence <80%, all of which were to oral medications. Multivariate regression analysis revealed only a diagnosis of Crohn’s disease (OR 4.62; 95% CI 1.37–15.7; p=0.014) to be a predictor of adherence. Disease activity as defined by IBDSI (OR 0.43, 95% CI 0.13–1.45; p=0.139) and fecal calprotectin >250ug/L (OR 1.04, 95% CI 0.35–3.11; p=0.724), age >55 (OR 2.37, 95% CI 0.65–8.65; p=0.476), female sex (OR 0.38, 95% CI 0.097–1.52; p=0.150) and stress (OR 0.67, 95% CI 0.19–2.32; p=0.498) were not shown to be predictors. MARS-5 was compared to percentage adherence, showing moderate correlation (Pearson r=0.46). Logistic regression analysis showed each additional MARS-5 point was associated with a 1.7 times greater odds of >90% adherence. Conclusions We report a highly adherent Manitoba IBD cohort. A diagnosis of CD was the only predicitor of adherence. MARS-5 showed moderate correlation with mean percentage adherence values, suggesting it is a valid assessment tool for determining medication adherence in an IBD population. Funding Agencies None


2008 ◽  
Vol 134 (4) ◽  
pp. A-489-A-490 ◽  
Author(s):  
Stephen B. Hanauer ◽  
Stefan Schreiber ◽  
Ole O. Thomsen ◽  
Gary R. Lichtenstein ◽  
Ralph Bloomfield ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Lingya Yao ◽  
Xiao Zhu ◽  
Bule Shao ◽  
Rongbei Liu ◽  
Zhilun Li ◽  
...  

Background and Aims: Ustekinumab (UST) was approved in China for treating moderate-to-severe Crohn’s disease (CD) in 2020. We aimed to identify the reasons and possible contributing factors for UST preference in Chinese patients with CD.Methods: We conducted a multicenter cross-sectional survey among patients with moderate to severe CD who underwent UST treatment in 27 hospitals. Patients completed a 46-item questionnaire that included information on demographics, clinical characteristics, reasons in favor of UST and shared decision-making perception. Logistic regression analysis was performed to examine the predictive factors of different UST preferences.Results: Overall, 127 patients (73 males; mean age, 25.9 ± 9.9 years) completed the questionnaire. Most patients (74.8%) had biologic failure. The most common reason for the latest treatment disconnection was unresponsiveness to the previous medications. The major UST information sources were physicians (96.1%). Nearly half of the patients (44.9%) reported shared decision making regarding UST treatment. No difference was found in the decision-making patterns in terms of sex and age. The most influential reason for UST preference was “effectiveness” (77%, 98/127), followed by “safety” (65%, 83/127), “frequency of administration” (39%, 49/127), and “mode of administration” (37%, 47/127). Multivariate logistic regression analysis revealed that a positive self-rated health status was a contributing factor for UST preference with a low frequency of administration.Conclusion: This is the first multicenter survey of Chinese patients with CD to identify the possible contributing factors for UST preference. Treatment choice should be discussed with patients because individual preferences are determined by diverse factors.


2019 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Megawati Sinambela ◽  
Evi Erianty Hasibuan

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Atsushi Kotera

Abstract Background Postanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries. Method This study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS. Results I retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015). Conclusions My result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.


2021 ◽  
Vol 12 ◽  
pp. 215145932199616
Author(s):  
Robert Erlichman ◽  
Nicholas Kolodychuk ◽  
Joseph N. Gabra ◽  
Harshitha Dudipala ◽  
Brook Maxhimer ◽  
...  

Introduction: Hip fractures are a significant economic burden to our healthcare system. As there have been efforts made to create an alternative payment model for hip fracture care, it will be imperative to risk-stratify reimbursement for these medically comorbid patients. We hypothesized that patients readmitted to the hospital within 90 days would be more likely to have a recent previous hospital admission, prior to their injury. Patients with a recent prior admission could therefore be considered higher risk for readmission and increased cost. Methods: A retrospective chart review identified 598 patients who underwent surgical fixation of a hip or femur fracture. Data on readmissions within 90 days of surgical procedure and previous admissions in the year prior to injury resulting in surgical procedure were collected. Logistic regression analysis was used to determine if recent prior admission had increased risk of 90-day readmission. A subgroup analysis of geriatric hip fractures and of readmitted patients were also performed. Results: Having a prior admission within one year was significantly associated (p < 0.0001) for 90-day readmission. Specifically, logistic regression analysis revealed that a prior admission was significantly associated with 90-day readmission with an odds ratio of 7.2 (95% CI: 4.8-10.9). Discussion: This patient population has a high rate of prior hospital admissions, and these prior admissions were predictive of 90-day readmission. Alternative payment models that include penalties for readmissions or fail to apply robust risk stratification may unjustly penalize hospital systems which care for more medically complex patients. Conclusions: Hip fracture patients with a recent prior admission to the hospital are at an increased risk for 90-day readmission. This information should be considered as alternative payment models are developed for hip fracture care.


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