The Journal of surgical research · 2026
Risk Factors for Early Intestinal Resection in Pediatric Crohn's Disease: A Nationwide Cohort Study.
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Bajzát Dorina, Imrei Marcell, Nagy Rita, Párniczky Andrea, Gede Noémi, Hegyi Péter, Karoliny Anna, Szentannay Judit, Czelecz Judit, Cseh Áron, Béres Nóra Judit, Tóth Melinda M, Kovács Márta, Guthy Ildikó, Lásztity Natália, Kadenczki Orsolya, Szakos Erzsébet, Szűcs Dániel, Vass Noémi, Tárnok András, Müller Katalin Eszter
Аннотация
INTRODUCTION: Complicated disease affects a substantial proportion of pediatric Crohn's disease (CD) patients and leads to surgery. A subset of children requires intestinal resection shortly after diagnosis. Several risk factors for surgery are known; however, the predictors of these early resections have not been well defined. We aimed to characterize this patient group and identify risk factors associated with early intestinal resections.
METHODS: We performed a retrospective analysis of patients under 18 y diagnosed with CD between 2010 and 2019, based on the Hungarian Pediatric inflammatory bowel disease Registry. We compared those patients who underwent intestinal resection within 6 mo after diagnosis (very early surgery group, VES) with those who did not require resection within 6 mo. Descriptive statistics and logistic regressions were used for the analysis.
RESULTS: Out of 1040 newly diagnosed pediatric CD patients, 27 (2.6%) underwent intestinal resection within 6 mo of diagnosis. The mean age of the two groups did not significantly differ. The proportion of females was significantly higher in the VES group (63.0% versus 42.3%, P = 0.03). Multivariate analysis identified abdominal pain without diarrhea (odds ratio [OR]: 5.59; P = 0.02) and higher pediatric CD activity index (OR: 1.05; P = 0.02) as risk factors for VES. Diagnostic delay (OR: 0.99; P = 0.74) and perianal involvement (OR 2.84; P = 0.12) were not predictive for VES.
CONCLUSIONS: VES is rare in pediatric CD, with a possible female predominance. Higher pediatric CD activity index at diagnosis indicates greater risk for early surgery.
METHODS: We performed a retrospective analysis of patients under 18 y diagnosed with CD between 2010 and 2019, based on the Hungarian Pediatric inflammatory bowel disease Registry. We compared those patients who underwent intestinal resection within 6 mo after diagnosis (very early surgery group, VES) with those who did not require resection within 6 mo. Descriptive statistics and logistic regressions were used for the analysis.
RESULTS: Out of 1040 newly diagnosed pediatric CD patients, 27 (2.6%) underwent intestinal resection within 6 mo of diagnosis. The mean age of the two groups did not significantly differ. The proportion of females was significantly higher in the VES group (63.0% versus 42.3%, P = 0.03). Multivariate analysis identified abdominal pain without diarrhea (odds ratio [OR]: 5.59; P = 0.02) and higher pediatric CD activity index (OR: 1.05; P = 0.02) as risk factors for VES. Diagnostic delay (OR: 0.99; P = 0.74) and perianal involvement (OR 2.84; P = 0.12) were not predictive for VES.
CONCLUSIONS: VES is rare in pediatric CD, with a possible female predominance. Higher pediatric CD activity index at diagnosis indicates greater risk for early surgery.