Institutional members access full text with Ovid®

Share this article on:

Development of a Novel Predictive Model for the Clinical Course of Crohn's Disease: Results from the CONNECT Study

Park, Yehyun MD*; Cheon, Jae Hee MD, PhD*; Park, Yi Lang RN*; Ye, Byong Duk MD, PhD; Kim, You Sun MD, PhD; Han, Dong Soo MD, PhD§; Kim, Joo Sung MD, PhD; Hong, Sung Noh MD; Kim, Young Ho MD, PhD; Jeon, Seong Ran MD**; Kim, Won Ho MD, PhD*IBD Study Group of the Korean Association for the Study of Intestinal Diseases (KASID)

doi: 10.1097/MIB.0000000000001106
Future Directions and Methods for IBD Research

Background: A considerable number of patients with Crohn's disease (CD) develop irreversible intestinal damage, although the early administration of immunomodulatory or biological therapies might prevent this. The aims of our study were to develop and validate a novel predictive model that can be used to predict the risk of surgical intervention in Korean patients with CD.

Methods: The prognostic model was derived from the multicenter longitudinal CONNECT (CrOhn's disease cliNical NEtwork and CohorT) study cohort consisting of 1338 patients with CD, who were split into training and validation sets. The Korean Crohn's Disease Prediction (KCDP) model was developed with the training set data using the Cox proportional hazards model and multivariate analysis, and was then validated using the validation set.

Results: A total of 1271 patients with CD were analyzed. During the follow-up period of 10,188 patient-years (median 7.1 yrs), 361 patients (28.4%) underwent CD-related surgery. Age at diagnosis, jejunal involvement, initial disease behavior, and perianal disease at diagnosis were associated with a poor prognosis and included in the KCDP model, which showed a modest discrimination ability with a Harrel's c-index of 0.731 at 5 years, and was well calibrated (Hosmer–Lemeshow χ2 = 8.230, P = 0.511).

Conclusions: This is the first validated surgery risk prediction model for Korean patients with CD; it provides accurate individualized estimates of the probability of surgery using clinical parameters collected at diagnosis. This model might guide appropriate patient selection for the early intensive treatment of CD.

Article first published online 13 April 2017.

*Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea;

Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea;

Department of Internal Medicine, Inje University College of Medicine, Seoul, Republic of Korea;

§Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea;

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea;

Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and

**Department of Internal Medicine, Soonchunhyang University School of Medicine, Seoul, Republic of Korea.

Address correspondence to: Jae Hee Cheon, MD, PhD, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun–gu, Seoul 03722, South Korea (e-mail: geniushee@yuhs.ac).

The authors have no conflict of interest to disclose.

Received December 27, 2016

Accepted February 21, 2017

© Crohn's & Colitis Foundation
You currently do not have access to this article

To access this article:

Note: If your society membership provides full-access, you may need to login on your society website