scholarly journals Prevalence of Sarcopenia and Its Effect on Postoperative Complications in Patients with Crohn’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Chen Zhang ◽  
Dingye Yu ◽  
Liwen Hong ◽  
Tianyu Zhang ◽  
Hua Liu ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Bowel Resection ◽  
Demographic Data ◽  
Laboratory Data ◽  
Intestinal Fistula ◽  
Tertiary Referral Center ◽  
Preoperative Serum

Background and Aims. Sarcopenia is a prognostic factor of outcomes for various diseases, but reports on sarcopenia in patients with Crohn’s disease (CD) are few. We aim to determine the prevalence of sarcopenia and assess the role of sarcopenia in postoperative complications in patients with CD at a tertiary referral center. Methods. Patients who underwent intestinal surgery for CD from January 2013 to October 2019 were retrospectively enrolled. The L3 skeletal muscle mass index (SMI) was used to identify sarcopenia. Demographic data, preoperative laboratory data, surgical details, and hospital outcomes were recorded. The factors associated with postoperative complications were evaluated through univariate and multivariate analyses. Results. One hundred and twenty-four patients were enrolled. Thirty-four of them (27.4%), including 11 males, were diagnosed with sarcopenia. Compared with patients without sarcopenia, sarcopenic patients had a significantly lower BMI ( P < 0.001 ); lower preoperative serum albumin ( P = 0.006 ), prealbumin ( P = 0.030 ), and hemoglobin levels ( P < 0.001 ); longer hospital stay ( 34.4 ± 26.8 days vs. 22.8 ± 15.6 days, P = 0.003 ); and more occurrences of complications (41.2% vs. 23.3%, P = 0.049 ). The overall incidence of postoperative complications was 28.2%. Infection (51.4%) and intestinal fistula (22.9%) were the most common among such complications. Through the multivariate analysis, sarcopenia was identified as an independent risk factor for major postoperative complications ( odds   ratio = 3.974 , 95 % CI = 1.171 –13.489, P = 0.027 ). Conclusion. Sarcopenia is common in patients with CD requiring bowel resection, and it significantly increases the risk of major postoperative complications.

scholarly journals Prevalence of Sarcopenia and Its Effect on Postoperative Complications in Patients With Crohn’s Disease

2021 ◽  
Author(s):  
Chen Zhang ◽  
Dingye Yu ◽  
Liwen Hong ◽  
Tianyu Zhang ◽  
Hua Liu ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Bowel Resection ◽  
Demographic Data ◽  
Laboratory Data ◽  
Intestinal Fistula ◽  
Tertiary Referral Center ◽  
Preoperative Serum

Abstract Background and Aims: Sarcopenia is a prognostic factor of outcomes for various diseases, but reports on sarcopenia in patients with Crohn’s disease (CD) are few. We aim to determine the prevalence of sarcopenia and assess the role of sarcopenia in postoperative complications in patients with CD at a tertiary referral center.Methods: Patients who underwent intestinal surgery for CD from January 2013 to October 2019 were retrospectively enrolled. The L3 skeletal muscle mass index (SMI) was used to identify sarcopenia. Demographic data, preoperative laboratory data, surgical details, and hospital outcomes were recorded. The factors associated with postoperative complications were evaluated through univariate and multivariate analyses.Results: One hundred and twenty-four patients were enrolled. Thirty-four of them (27.4%), including 11 males, were diagnosed with sarcopenia. Compared with patients without sarcopenia, sarcopenic patients had a significantly lower BMI (P<0.001); lower preoperative serum albumin (P=0.006), pro-albumin (P=0.030), and hemoglobin levels (P<0.001); longer hospital stay (34.4±26.8 days vs. 22.8±15.6 days, P=0.003); and more occurrences of complications (41.2% vs. 23.3%, P=0.049). The overall incidence of postoperative complications was 28.2%. Infection (51.4%) and intestinal fistula (22.9%) were the most common among such complications. Through the multivariate analysis, sarcopenia was identified as an independent risk factor for major postoperative complications (odds ratio=3.974, 95% CI=1.171–13.489, P=0.027).Conclusion: Sarcopenia is common in patients with CD requiring bowel resection, and it significantly increases the risk of major postoperative complications.

scholarly journals Osteoporosis of Crohn’s Disease: A Critical Review

1996 ◽  
Vol 10 (5) ◽  
pp. 317-321
Author(s):  
Neena S Abraham ◽  
Richard N Fedorak
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Bone Density ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Treatment Of Osteoporosis ◽  
Present Understanding

Osteoporosis has long been a recognized complication of Crohn’s disease (CD), with a documented incidence ranging from 31% to 65%. The cause of osteoporosis in Crohn’s patients is likely multifactorial; corticosteroids, inflammatory cytokines, small bowel resection and the resultant calcium and vitamin D deficiencies, hypogonadism, malnutrition and the cachexia of inflammation all play a role. However, the mechanism responsible for osteoporosis associated with CD remains unclear. Treatment of decreased bone density in CD patients has been limited to calcium and vitamin D replacement. The present understanding of the pathophysiology, mechanism and treatment of osteoporosis in CD is reviewed, with the focus on the role of steroid-induced osteoporosis and the use of bisphosphonates.

The Influence of Preoperative Medications on Postoperative Complications in Patients After Intestinal Surgery for Crohn’s Disease

2019 ◽  
Vol 25 (9) ◽  
pp. 1559-1568 ◽  
Author(s):  
Chang Sik Yu ◽  
Sung Woo Jung ◽  
Jong Lyul Lee ◽  
Seok-Byung Lim ◽  
In Ja Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Bowel Resection ◽  
Abdominal Sepsis ◽  
Infectious Complications ◽  
Time Of Surgery ◽  
Tnf Α ◽  
Resection And Anastomosis

Abstract Background Many patients with Crohn’s disease (CD) are treated with medications, including steroids, immunomodulators, and anti–tumor necrosis factor alpha (anti-TNF-α) agents, at the time of surgery. This study evaluated the effects of these medications on postoperative complications in CD patients. Methods This retrospective study analyzed patients who underwent bowel resection for CD between January 2006 and December 2015. Postoperative complications were defined as a Clavien-Dindo classification of grade 2A or higher within the first 30 days after surgery. Results Of the 817 patients enrolled, 687 patients received bowel resection and anastomosis without stoma formation. Of 687 patients, 381 (55.5%) were being treated with preoperative medications at the time of surgery (medication group) and 306 (44.5%) were not (nonmedication group). The overall rate of postoperative complications was not different between the medication and nonmedication groups (23.4% vs 21.9%, P = 0.36). Preoperative treatments with immunomodulators plus anti-TNF-α agents (relative risk [RR], 2.314; 95% confidence interval [CI], 1.126–4.753; P = 0.022) and treatment with immunomodulators plus steroids (RR, 2.536; 95% CI, 1.124–5.725; P = 0.025) were risk factors for infectious complications. Preoperative treatments with immunomodulators plus anti-TNF-α agents (RR, 2.731; 95% CI, 1.102–6.769; P = 0.03) and treatment with immunomodulators plus steroids (RR, 3.118; 95% CI, 1.169–8.320; P = 0.023) were significantly associated with increased risk of intra-abdominal sepsis. Conclusions Preoperative treatments with immunomodulators plus anti-TNF-α agents or steroids were risk factors for infectious complications, especially intra-abdominal sepsis in patients who underwent bowel resection and anastomosis.

1011 Higher Preoperative Serum Biologic Levels Are Associated With Postoperative Complications in Crohn's Disease Patients

2013 ◽  
Vol 144 (5) ◽  
pp. S-190 ◽  
Author(s):  
Cheryl C. Lau ◽  
Marla Dubinsky ◽  
Gil Y. Melmed ◽  
Eric A. Vasiliauskas ◽  
Dermot P. McGovern ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Preoperative Serum

P056 DISCRIMINATORY ROLE OF ANTI-MICROBIAL ANTIBODIES IN DIAGNOSIS OF CROHN'S DISEASE AGAINST NORMAL AND OTHER MIMICS

2020 ◽  
Vol 158 (3) ◽  
pp. S21-S22
Author(s):  
Peilin Zhang ◽  
Lawrence Minardi ◽  
J. Todd Kuenstner ◽  
Steve Zekan ◽  
Rusty Kruzelock
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease

THE EVALUATION OF SERUM SEROTONIN LEVEL AMONG PATIENTS WITH CROHN’S DISEASE AND ITS IMPACT ON QUALITY OF LIFE

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S55-S55
Author(s):  
Marcin Sochal ◽  
Piotr Bialasiewicz ◽  
Agata Gabryelska ◽  
Renata Talar-Wojnarowska ◽  
Jakub Fichna ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Sleep Quality ◽  
Sleep Fragmentation ◽  
Clinical Severity ◽  
Serotonin Level ◽  
Intestinal Physiology ◽  
Tnf Α

Abstract Background and aims Serotonin affects intestinal physiology, mood, as well as circadian rhythm. Moreover, serotonin has proinflammatory function. Therefore, the aim of this study was to investigate the role of serotonin in clinical severity of Crohn’s Disease (CD) and its effect on pain and sleep quality. Methods Fifty-nine CD patients (34 in exacerbation and 25 in remission according to the Harvey-Bradshaw Index-HBI) and 25 health control individuals(HC) were recruited. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and subjective severity of pain by the Visual Analog Scale (VAS). Seventeen patients were treated with anti-TNF-α induction therapy for 14 weeks. Results Serotonin level was higher in CD (145.12ng/mL, IQR:98.14–179.25) compared to HC (87.52ng/mL, IQR:70.04–129.39; p=0.002) and in exacerbation of CD (157.66ng/mL, IQR:111.94–197.64) compared to remission (122.33ng/mL, IQR:83.28–163.67; p=0.029). Serotonin level with cut-off point of 92.45 ng/mL is useful for distinguishing participants with CD from HC (sensitivity: 78%, specificity: 60%, positive predictive value: 82%). Positive correlation between serotonin and HBI (r=0.279, p=0.032) and severity of diarrhoea (r=0.260, p=0.047) were found. Serotonin does not correlate with PSQI (r=0.152, p=0.168), but correlates with presence of sleep fragmentation for example by getting up to use the bathroom (joined 5b-5j PSQI questions; r=0.270, p=0.039). Correlations between serotonin and VAS were also obtained (r=0.220, p=0.045). Moreover, serotonin level significantly decreased after anti-TNF-α therapy (192.35ng/mL, IQR:150.36–225.56 vs. 121.11ng/mL, IQR:91.28–188.87; p=0.006). The study was funded by National Science Centre, Poland (#2018/31/N/NZ5/03715). Conclusions Serotonin level correlates with the severity of CD and decreases after anti-TNF-α therapy. It is associated with sleep fragmentation, which may be caused by diarrhea.

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