Risk Factors and Outcomes of Emergency Room Visits in Intestinal Behçet’s Disease

Abstract

Background/Aims: Intestinal Behçet’s disease (BD) is a chronic recurring intestinal vasculitic disorder that can lead to emergency room (ER) visits. We aimed to investigate the independent risk factors associated with intestinal BD-related ER visits. Methods: We retrospectively reviewed 606 patients with intestinal BD registered at the Inflammatory Bowel Disease Clinic of Severance Hospital, Seoul, Korea. Results: One hundred eighty-five patients (30.5%) visited the ER at least once (total visits, 510). In multivariate analysis, lower socioeconomic status (hazard ratio [HR] 1.884), higher comorbidity index (HR 1.548), corticosteroid use (HR 1.459), higher C-reactive protein (CRP; HR 1.375), and higher disease activity index for intestinal BD (DAIBD) score (HR 1.013) were independent risk factors. However, older age (HR 0.982), disease duration (HR 0.850), opioid use (HR 0.528), and higher hemoglobin level (HR 0.944) were significantly associated with decreased ER visits. Conclusions: The ER attendance rate of patients with intestinal BD was 30.5%. Lower socioeconomic status, higher comorbidity index, corticosteroid use, higher CRP, and higher DAIBD score were positively associated with ER visits. Older age, disease duration, opioid use, and higher hemoglobin level were significantly associated with decreased ER visits.

Long‐term clinical outcomes of intestinal Behçet's disease: A 30‐year cohort study at a tertiary hospital in South Korea

“…Based on reports of the 5‐year course of intestinal BD, 74.6% of patients experience remission or mild disease activity, and 16.2% have multiple relapses or chronic symptoms 8 . Similar to inflammatory bowel disease (IBD), intestinal BD can present with perforation, peritonitis, or severe lower gastrointestinal bleeding requiring medical acceleration, intestinal surgery, hospitalization, or emergency room visits 9–13 . In a 10‐year follow‐up study, there were no differences in the cumulative probabilities of intestinal surgery, hospitalization, recurrence, and reoperation rates between Crohn's disease (CD) ( n = 332) and intestinal BD ( n = 276) 14 .…”

“…8 Similar to inflammatory bowel disease (IBD), intestinal BD can present with perforation, peritonitis, or severe lower gastrointestinal bleeding requiring medical acceleration, intestinal surgery, hospitalization, or emergency room visits. [9][10][11][12][13] In a 10-year follow-up study, there were no differences in the cumulative probabilities of intestinal surgery, hospitalization, recurrence, and reoperation rates between Crohn's disease (CD) (n = 332) and intestinal BD (n = 276). 14 Conversely, several studies have reported that prognosis is worse in intestinal BD than in CD.…”

Behсet's disease: intestinal damage

“…В табл. 7 представлена терапия в зависимости от тяжести ПКББ, согласно анализу ретроспективных исследований [45,[53][54][55][56][57][58][59].…”

“…[27] за 80 пациентами с ПКББ было установлено, что отсутствие заживления слизистой оболочки кишечника в момент клинической ремиссии является независимым предиктором рецидива ББ [27]. Заживление слизистой оболочки кишечника является важным прогностическим фактором и ассоциируется с длительной клинической ремиссией и снижением частоты госпитализации и хирургических вмешательств [58].…”

“…Терапия ББ в зависимости от индекса активности ПКББ, баллы [45,[53][54][55][56][57][58] ная частота хирургических вмешательств через год после установления диагноза составляет 20%, через 5 лет -27-33% и через 10 лет 31-46% [18,[59][60][61][62]. Отмечалась тенденция к значительному снижению частоты летальных исходов с увеличением длительности ББ и возраста больных [59].…”