Prognostische Faktoren bei Morbus Crohn: Ist die Wahrscheinlichkeit einer späteren Operation bei Erstdiagnose abschätzbar?

: Data were retrospectively analysed of 492 patients (268 women, 224 men; mean age 27 [9-71] years) to find out what features present at time of first diagnosis (age, sex, site of disease, biochemical findings) will play a role in determining the probability of surgery ultimately becoming necessary. The probability of an operation ten years after first diagnosis was 55%, after 20 years it was 88%, significantly higher if the ileum rather than only the colon was affected. Age and sex had no influence. Patients with a haemoglobin content below 12 g/dl (women) or below 13.5 g/dl (men), or an albumin concentration under 4.0 g/dl, or a blood sedimentation rate over 30 mm in the first hour had a probability of operation after ten years nearly three times higher than those without one of these findings. A prognosis about the likely future course of the disease can be made from its localization and the biochemical values. Thus patients with an early ileocolitis and unfavourable biochemical findings apparently constitute a subgroup in which the disease takes a primarily aggressive course.