scholarly journals Effects of ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition on postoperative complications for patients with Crohn’s disease: a cohort study

2020 ◽  
Author(s):  
Yan Wu ◽  
Huaying Liu ◽  
Weilin Qi ◽  
Wei Liu ◽  
Shasha Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Parenteral Nutrition ◽  
Eligible Patient ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Post Surgery ◽  
Complication Risk

Abstract Background: Most patients with Crohn's disease (CD), a chronic inflammatory disease, need surgery but exhibit elevated postoperative complication incidences. ω-3 polyunsaturated fatty acids (PUFAs) are considered beneficial for nutrition, anti-inflammation, immunity and intestinal microflora balance in humans. This study assessed the effects of ω-3 PUFA-supplemented parenteral nutrition (PN) on postoperative complications in CD.Methods: Overall, 186 CD patients undergoing bowel resection were eligible. Patient data were collected from a prospectively maintained database. After surgery, 103 patients received ω-3 PUFA-supplemented PN; 83 did not. Postoperative complications were compared between the groups. Complication risk factors were identified by univariate and multivariate analyses.Results: Patients with ω-3 PUFA-supplemented PN after surgery had lower C-reactive protein levels (57.2±5.3 mg/L vs 43.5±3.9 mg/L, P=0.047) and shorter postoperative hospital stays (12.1±1.1 days vs 9.3±0.6 days, P=0.041) than those without. The ω-3 PUFA group exhibited significantly reduced incidences of overall complications (40.8% vs 24.1%, P=0.016) and major complications (23.3% vs 9.6%, P=0.014). Postoperative complications were associated with infliximab, ω-3 PUFAs, C-reactive protein, operative time, and laparoscopic surgery. Multivariate regression revealed that preoperative infliximab use and postoperative ω-3 PUFA-supplemented PN were independent risk factors in CD. Conclusions: ω-3 PUFA-supplemented PN reduced post-surgery inflammatory response in CD patients, thus decreasing postoperative complications and accelerating recovery.Trial registration: This trial was registered in ClinicalTrials.gov. Identifier was NCT03901937. The date of registration was 03/04/2019.

scholarly journals Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hangfen Zhao ◽  
Huaying Liu ◽  
Weilin Qi ◽  
Wei Liu ◽  
Lingna Ye ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Surgical Site Infections ◽  
Predictive Marker ◽  
Roc Curves ◽  
Youden Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Independent Risk Factor

Background. The ratio of C-reactive protein (CRP) to albumin (CAR) has a significant correlation with postoperative complications and acts as a predictor in patients with pancreatic cancer and colorectal cancer. However, whether the CAR can be used to predict complications in Crohn’s disease (CD) patients after surgery has not yet been reported. Methods. A total of 534 CD patients undergoing surgery between 2016 and 2020 were enrolled. The risk factors of postoperative complications were assessed by univariate and multivariate analyses. The cutoff values and the accuracy of diagnosis for the CAR and postoperative CRP levels were examined with receiver operating characteristic (ROC) curves. Results. The rate of postoperative complications was 32.2%. The postoperative CAR (OR 13.200; 95% CI 6.501-26.803; P < 0.001 ) was a significant independent risk factor for complications. Compared with the CRP level on postoperative day 3, the CAR more accurately indicated postoperative complications in CD patients (AUC: 0.699 vs. 0.771; Youden index: 0.361 vs. 0.599). ROC curves showed that the cutoff value for the CAR was 3.25. Patients with a CAR ≥ 3.25 had more complications ( P < 0.001 ), a longer postoperative stay ( 15.5 ± 0.6  d vs. 9.0 ± 0.2  d, P < 0.001 ), and more surgical site infections (48.2% vs. 5.7%, P < 0.001 ) than those with a CAR < 3.25 . Conclusions. Compared to the CRP level, the CAR can more accurately predict postoperative complications and can act as a predictive marker in CD patients after surgery.

Combined evaluation of fecal calprotectin and C-reactive protein as a therapeutic target in the management of patients with Crohn's disease

2021 ◽  
Vol 44 (2) ◽  
pp. 87-95
Author(s):  
Francisco Guilherme Cancela Penna ◽  
Rodrigo Macedo Rosa ◽  
Fernando H. Pereira ◽  
Pedro Ferrari Sales Cunha ◽  
Stella Cristina S. Sousa ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Therapeutic Target ◽  
Fecal Calprotectin ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Combined Evaluation

Correlation between levels of C-reactive protein and clinical activity in Crohn's disease

2007 ◽  
Vol 39 (11) ◽  
pp. 1006-1010 ◽  
Author(s):  
S. Karoui ◽  
S. Ouerdiane ◽  
M. Serghini ◽  
T. Jomni ◽  
L. Kallel ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Activity ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Causes and Prognosis of Intestinal Failure in Crohn’s Disease: An 18-year Experience From a National Centre

2020 ◽  
Vol 14 (11) ◽  
pp. 1558-1564 ◽  
Author(s):  
Mattias Soop ◽  
Haroon Khan ◽  
Emma Nixon ◽  
Antje Teubner ◽  
Arun Abraham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Parenteral Nutrition ◽  
Intestinal Failure ◽  
Anastomotic Dehiscence ◽  
Septic Complication ◽  
Kaplan Meier

Abstract Background and Aims Intestinal failure [IF] is a feared complication of Crohn’s disease [CD]. Although cumulative loss of small bowel due to bowel resections is thought to be the dominant cause, the causes and outcomes have not been reported. Methods Consecutive adult patients referred to a national intestinal failure unit over 2000–2018 with a diagnosis of CD, and subsequently treated with parenteral nutrition during at least 12 months, were included in this longitudinal cohort study. Data were extracted from a prospective institutional clinical database and patient records. Results A total of 121 patients were included. Of these, 62 [51%] of patients developed IF as a consequence of abdominal sepsis complicating abdominal surgery; small bowel resection, primary disease activity, and proximal stoma were less common causes [31%, 12%, and 6%, respectively]. Further, 32 had perianastomotic sepsis, and 15 of those had documented risk factors for anastomotic dehiscence. On Kaplan-Meier analysis, 40% of all patients regained nutritional autonomy within 10 years and none did subsequently; 14% of patients developed intestinal failure-associated liver disease. On Kaplan-Meier analysis, projected mean age of death was 74 years.2 Conclusions IF is a severe complication of CD, with 60% of patients permanently dependent on parenteral nutrition. The most frequent event leading directly to IF was a septic complication following abdominal surgery, in many cases following intestinal anastomosis in the presence of significant risk factors for anastomotic dehiscence. A reduced need for abdominal surgery, an increased awareness of perioperative risk factors, and structured pre-operative optimisation may reduce the incidence of IF in CD.

Plasma Arachidonic Acid-Rich Phospholipids in Crohn's Disease: Response to Treatment

1996 ◽  
Vol 91 (4) ◽  
pp. 509-512 ◽  
Author(s):  
Stephen P. Pereira ◽  
Theresa B. Cassell ◽  
Jeffrey L Engelman ◽  
Gordon E. Sladen ◽  
Gerard M. Murphy ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Polyunsaturated Fatty Acids ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Polyunsaturated Phosphatidylcholine

1. Increased concentrations of plasma polyunsaturated fatty acids have been implicated in the pathogenesis of Crohn's disease. However, it is not known whether there are corresponding changes in circulating phospholipids - the major source of fatty acids in the plasma. 2. Fasting plasma samples were obtained from 17 control subjects and 13 patients with active Crohn's disease [Simple Index of Crohn's Disease Activity (SICDA) >6] before, and 2 and 8 weeks after, treatment with either a peptide diet or oral prednisolone. 3. Before treatment, the Crohn's disease patients had mildly active disease (SICDA 9.9 ± 0.8, erythrocyte sedimentation rate 26.4 ± 6.5 mm/h, serum C-reactive protein 2.8 ± 0.4 mg/l). The proportions of the polyunsaturated phosphatidylcholine species, 16:0–20:4 (10.0 ± 0.7%) and 16:0–22:6 (7.1 ± 0.8%), were both significantly higher than those in healthy controls (7.6 ± 0.5%, P < 0.01 and 5.3 ± 0.5%, P < 0.05 respectively). 4. After 2 weeks treatment, the SICDA in the Crohn's disease patients decreased to 3.2 ± 0.6 (P < 0.0001 compared with the pretreatment value), and there were corresponding falls in the erythrocyte sedimentation rate (to 12.6 ± 2.7 mm/h, P < 0.05) and C-reactive protein concentration (to 1.7 ± 0.3 mg/l, P < 0.05)—these improvements being maintained at 8 weeks. There was also a fall to normal values in 16:0–20:4 (to 7.7 ± 0.6%, P < 0.01 compared with the pretreatment value) and in 16:0–22:6 (to 5.7 ± 0.5%, P not significant), by week 8. 5. The proportions of polyunsaturated phosphatidylcholine molecular species were increased in the plasma of patients with active Crohn's disease, but fell to normal levels during disease remission. These observations are consistent with the theory that, in active Crohn's disease, the mucosal phospholipids containing polyunsaturated fatty acids are increased, contribute to eicosanoid synthesis and ‘spill’ into the plasma.

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