Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov;21(11):1279-1287.
doi: 10.1111/codi.14731. Epub 2019 Jul 5.

Reduction in surgical stoma rates in Crohn's disease: a population-based time trend analysis

C Ma  1   2 , A Almutairdi  1   3 , D Tanyingoh  4 , C H Seow  1 , K L Novak  1 , C Lu  1 , R Panaccione  1 , G G Kaplan  1   4 , P G Kotze  1   5
Affiliations

Reduction in surgical stoma rates in Crohn's disease: a population-based time trend analysis

C Ma et al. Colorectal Dis. 2019 Nov.

Abstract

Aim: Trends in surgical rates for Crohn's disease (CD) in the biological era are controversial. We aim to assess modern trends in the formation rates of surgical stomas.

Method: Population-based surveillance in the Calgary Health Zone (CHZ), Canada, was conducted between 1 April 2002 and 31 March 2011, using the Discharge Abstract Database to identify adult patients with CD admitted to hospital and treated with surgical stoma formation (n = 545). Annual stoma incidence was calculated by dividing the number of incident stomas by the prevalence of CD in the CHZ. Time trend analysis of the stoma-formation rate was performed, expressed as annual percentage change (APC) with 95% CI. Stoma-formation rates were stratified according to procedure (emergency vs elective) and duration of stoma [temporary (reversed within 2 years of formation) vs permanent].

Results: The overall rate of stoma formation between 2002 and 2011 showed a downwards trend, of a mean of 5.2% (95% CI: -8.5 to -1.8) per year, from a rate of 2.30 stomas/100 person-years (PY) in 2002 to 1.51 stomas/100 PY in 2011. The rate of emergency stoma formation decreased significantly from 2002 to 2011 (mean APC = -9.4%; 95% CI: -15.6 to -2.8), while the rate of elective ostomies essentially showed no change (mean APC = -0.9%; 95% CI: -5.3 to 3.8). The rate of temporary stoma formation decreased significantly, by 4.6% (95% CI: -7.3 to -1.8) per year, while permanent stoma formation was stable (APC = 1.0%; 95% CI: -4.0 to +6.3).

Conclusion: A reduction in the overall rate of stoma formation in CD has been driven by fewer emergency stomas, although rates of permanent stoma have remained stable.

Keywords: Crohn's disease; Stoma; colostomy; ileostomy; surgery.

PubMed Disclaimer

References

    1. Baumgart DC, Sandborn WJ. Crohn's disease. Lancet 2012; 380: 1590-605.
    1. Bemelman WA, Warusavitarne J, Sampietro GM et al. ECCO-ESCP consensus on surgery for Crohn's disease. J Crohns Colitis 2018; 12: 1-16.
    1. Frolkis AD, Dykeman J, Negron ME et al. Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta-analysis of population-based studies. Gastroenterology 2013; 145: 996-1006.
    1. Ma C, Moran GW, Benchimol EI et al. Surgical rates for Crohn's disease are decreasing: a population-based time trend analysis and validation study. Am J Gastroenterol 2017; 112: 1840-8.
    1. Frolkis AD, Lipton DS, Fiest KM et al. Cumulative incidence of second intestinal resection in Crohn's disease: a systematic review and meta-analysis of population-based studies. Am J Gastroenterol 2014; 109: 1739-48.

LinkOut - more resources