Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn’s Disease

Yoshifumi Watanabe, Norikatsu Miyoshi, Shiki Fujino, Hidekazu Takahashi, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori, Tsunekazu Mizushima

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Background: Intestinal failure is the most critical complication of Crohn’s disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications. Aims: The purpose of this study was to investigate the incidence and risk factors for intestinal failure in Crohn’s disease. Methods: We performed a retrospective analysis of Crohn’s disease patients (162 cases) at Osaka University Hospital between January 2000 and December 2017. Kaplan–Meier analysis was used to investigate the cumulative incidence of intestinal failure. To identify the risk factors of intestinal failure, patient characteristics were analyzed by multivariate analysis, including disease classification, surgical history, medical treatment other than surgery, and cumulative inflammation was calculated using the average C-reactive protein value and disease duration. Results: The cumulative incidence of intestinal failure 5, 10, and 15 years after Crohn’s disease diagnosis was 2.6%, 3.4%, and 8.6%, respectively. Multivariate analysis identified the following as independent risk factors for intestinal failure in Crohn’s disease: residual small intestinal length < 200 cm (odds ratio 7.51, 95% confidence interval 2.14–29.96), non-use of anti-tumor necrosis factor-alpha therapy (3.34, 1.22–10.74), and cumulative inflammation (1.01, 1.001–1.038). We created a new predictive nomogram consisting of these risk factors. Conclusions: Intestinal failure occasionally occurred during long-term treatment of Crohn’s disease. Cumulative inflammation for the first time, in addition to short residual small intestinal length and non-use of anti-tumor necrosis factor-alpha therapy, was shown to be potential risk factors for intestinal failure in Crohn’s disease.

Original languageEnglish
Pages (from-to)2280-2285
Number of pages6
JournalDigestive Diseases and Sciences
Issue number8
Publication statusPublished - Aug 15 2019

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology


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