An epidemiological study of pediatric-onset Crohn's disease: relationship between nature of disease and outcome

Critch, Jeffrey (2004) An epidemiological study of pediatric-onset Crohn's disease: relationship between nature of disease and outcome. Masters thesis, Memorial University of Newfoundland.

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Abstract

Objective: To identify baseline variables predictive of severity of pediatric-onset Crohn's disease during the first year following diagnosis. -- Study Design: Prospective inception cohort study. -- Participants/Setting: Pediatric patients (aged <17 years) newly diagnosed with Crohn's disease at the Hospital for Sick Children, Toronto, Canada from July 1997 - May 2001. -- Methods: The primary outcome variable was disease severity as measured by Physicians Global Assessment (quiescent/mild, moderate/severe). The influence of pre-selected baseline variables (gender, disease location, laboratory parameters, initial corticosteroid therapy, response to initial therapy and PCDAl scores) on disease severity was determined by multivariate analysis. -- Results: In follow-up of 122 patients, 73 had quiescent/mild disease and 49 moderate/severe disease. Univariate analysis demonstrated moderate/severe disease was associated with low albumin (p=0.004), high PCDAl (p<0.001), initial hospitalization (p=0.004), initial corticosteroids use (p=0.003) and partial/no response to initial therapy (p=0.028). In multivariate regression analysis, PCDAI score was the best single predictor of subsequent disease severity (p<0.001, R2 =0.16). -- Conclusion: Disease activity at diagnosis is predictive of disease severity during the first year in pediatric-onset Crohn’s disease.

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