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. 2025 Dec 6.
doi: 10.1002/ueg2.70150. Online ahead of print.

Comparative Study on the Management and Outcomes of Postoperative Crohn's Disease in Older Patients: Data From the ENEIDA Registry

Míriam Mañosa  1   2 , Margalida Calafat  1   2 , Elena Ricart  2   3 , Pilar Nos  4 , Eva Iglesias  5 , Sabino Riestra  6 , Francisco Mesonero  7 , Marta Calvo  8 , Jordi Guardiola  9 , Vicent Hernández  10 , Montserrat Rivero  11 , Daniel Carpio  12 , Miguel Mínguez  13 , Cristina Alba  14 , Maria Dolores Martín-Arranz  15 , Milagros Vela  16 , Fernando Gomollón  17 , Santiago García-López  18 , Ana Gutiérrez Casbas  2   19 , Xavier Calvet  2   20 , Carlos González-Muñoza  21 , Jesús Barrio  22 , Javier P Gisbert  2   23 , Beatriz Sicilia  24 , José Lázaro Pérez-Calle  25 , Luis Bujanda  2   26 , Maria Esteve  2   27 , Laura Ramos  28 , Pilar Varela  29 , Mónica Sierra  30 , Olga Merino  31 , Fernando Bermejo  32 , Manuel Barreiro-de Acosta  33 , Antonio Rodríguez Perez  34 , Lucía Márquez-Mosquera  35 , Orlando García-Bosch  36 , Iago Rodríguez-Lago  37 , Rufo H Lorente Poyatos  38 , Mariana Fe García Sepulcre  39 , Nuria Maroto  40 , Pablo Vega  41 , David Monfort  42 , Lucía Zabalsa San Martín  43 , David Busquets  44 , Pilar Martinez-Montiel  45 , Joan Riera  46 , Guillermo Alcain  47 , Jordina Llaó  48 , Nacho Marin  49 , Ignacio Marin-Jimenez  50 , Eva Sesé  51 , Manuel Van Domselaar  52 , José M Huguet  53 , Daniel Ginard  54 , Francesc Bas-Cutrina  55 , Yolanda Ber  56 , Oscar Roncero  57 , Alfredo J Lucendo  2   58 , Alicia López-García  59 , Margarita Menacho  60 , Pedro Almela  61 , Ángel Ponferrada  62 , Ana Fuentes Coronel  63 , Sergio Maestro  64 , Teresa de Jesús Martínez-Pérez  65 , Carmen Muñoz Vilafranca  66 , Federico Argüelles  67 , Jesús Legido  68 , Pau Gilabert  69 , Mara Charro  70 , Ana M Trapero  71 , Hipólito Fernández  72 , Santiago Frago  73 , Luis Hernández Villalba  74 , Esther Muñoz  75 , Eugeni Domènech  1   2 ; ENEIDA registry of GETECCU
Affiliations
Free article

Comparative Study on the Management and Outcomes of Postoperative Crohn's Disease in Older Patients: Data From the ENEIDA Registry

Míriam Mañosa et al. United European Gastroenterol J. .
Free article

Abstract

Background: Limited data are available on the management and outcomes of postoperative Crohn's disease (CD) in older patients. We aimed to describe the management of CD in the postoperative setting and assess surgical postoperative recurrence (POR) in this population.

Methods: This was a case-control study including all adult patients with CD from the ENEIDA registry who had undergone a first intestinal resection with ileo-colonic anastomosis. Patients were grouped according to their age at the time of the first surgery in older (over 60 years) subjects and controls (between 18 and 60 years of age).

Results: A total of 3982 (535 older subjects and 3454 controls) underwent a first intestinal resection for CD with an ileo-colonic anastomosis. Time from CD diagnosis to surgery was significantly longer in older patients (114 ± 128 vs. 93 ± 97 months; p < 0.001). Older patients also had a lower proportion of penetrating CD (25% vs. 39%; p < 0.0001) and perianal disease (14% vs. 25%; p < 0.0001). A significantly lower proportion of older patients started preventive therapies for POR (32% vs. 51%; p < 0.0001). The cumulative risk of surgical POR was 3.2%, 5.3% and 10.1% in the older group and 3.6%, 6.6% and 14.2% in the control group at three, five and 10 years, respectively (p = 0.093). In the multivariate logistic regression analysis, only prevention with thiopurines was associated with a lower risk of surgical POR.

Conclusions: Although postoperative preventive therapy with immunomodulators or biologicals is prescribed less often in older patients after a first intestinal resection, they develop surgical POR as often as younger adult patients.

Keywords: Crohn's disease; older; postoperative recurrence; surgery.

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