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The Association of Smoking and Surgery in Inflammatory Bowel Disease is Modified by Age at Diagnosis

We assessed the association of smoking at diagnosis of inflammatory bowel disease (IBD) on the need for an intestinal resection. The Health Improvement Network was used to identify an inception cohort of Crohn's disease (n=1519) and ulcerative colitis (n=3600) patients from 1999-2009. Poisson regres... Full description

Journal Title: Clinical and Translational Gastroenterology 2016-04-21, Vol.7 (4), p.e165-e165
Main Author: Frolkis, Alexandra D
Other Authors: de Bruyn, Jennifer , Jette, Nathalie , Lowerison, Mark , Engbers, Jordan , Ghali, William , Lewis, James D , Vallerand, Isabelle , Patten, Scott , Eksteen, Bertus , Barnabe, Cheryl , Panaccione, Remo , Ghosh, Subrata , Wiebe, Samuel , Kaplan, Gilaad G
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
ID: ISSN: 2155-384X
Link: https://www.ncbi.nlm.nih.gov/pubmed/27101004
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4855162
title: The Association of Smoking and Surgery in Inflammatory Bowel Disease is Modified by Age at Diagnosis
format: Article
creator:
  • Frolkis, Alexandra D
  • de Bruyn, Jennifer
  • Jette, Nathalie
  • Lowerison, Mark
  • Engbers, Jordan
  • Ghali, William
  • Lewis, James D
  • Vallerand, Isabelle
  • Patten, Scott
  • Eksteen, Bertus
  • Barnabe, Cheryl
  • Panaccione, Remo
  • Ghosh, Subrata
  • Wiebe, Samuel
  • Kaplan, Gilaad G
subjects:
  • digestive system diseases
  • Original Contributions
ispartof: Clinical and Translational Gastroenterology, 2016-04-21, Vol.7 (4), p.e165-e165
description: We assessed the association of smoking at diagnosis of inflammatory bowel disease (IBD) on the need for an intestinal resection. The Health Improvement Network was used to identify an inception cohort of Crohn's disease (n=1519) and ulcerative colitis (n=3600) patients from 1999-2009. Poisson regression explored temporal trends for the proportion of newly diagnosed IBD patients who never smoked before their diagnosis and the risk of surgery within 3 years of diagnosis. Cox proportional hazard models assessed the association between smoking and surgery, and effect modification was explored for age at diagnosis. The rate of never smokers increased by 3% per year for newly diagnosed Crohn's disease patients (incidence rate ratio (IRR) 1.03; 95% confidence interval (CI): 1.02-1.05), but not for ulcerative colitis. The rate of surgery decreased among Crohn's disease patients aged 17-40 years (IRR 0.96; 95% CI: 0.93-0.98), but not for ulcerative colitis. Smoking at diagnosis increased the risk of surgery for Crohn's disease patients diagnosed after the age of 40 (hazard ratio (HR) 2.99; 95% CI: 1.52-5.92), but not for those diagnosed before age 40. Ulcerative colitis patients diagnosed between the ages of 17 and 40 years and who quit smoking before their diagnosis were more likely to undergo a colectomy (ex-smoker vs. never smoker: HR 1.66; 95% CI: 1.04-2.66). The age-specific findings were consistent across sensitivity analyses for Crohn's disease, but not ulcerative colitis. In this study, the association of smoking and surgical resection was dependent on the age at diagnosis of IBD.
language: eng
source:
identifier: ISSN: 2155-384X
fulltext: no_fulltext
issn:
  • 2155-384X
  • 2155-384X
url: Link


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creatorFrolkis, Alexandra D ; de Bruyn, Jennifer ; Jette, Nathalie ; Lowerison, Mark ; Engbers, Jordan ; Ghali, William ; Lewis, James D ; Vallerand, Isabelle ; Patten, Scott ; Eksteen, Bertus ; Barnabe, Cheryl ; Panaccione, Remo ; Ghosh, Subrata ; Wiebe, Samuel ; Kaplan, Gilaad G
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descriptionWe assessed the association of smoking at diagnosis of inflammatory bowel disease (IBD) on the need for an intestinal resection. The Health Improvement Network was used to identify an inception cohort of Crohn's disease (n=1519) and ulcerative colitis (n=3600) patients from 1999-2009. Poisson regression explored temporal trends for the proportion of newly diagnosed IBD patients who never smoked before their diagnosis and the risk of surgery within 3 years of diagnosis. Cox proportional hazard models assessed the association between smoking and surgery, and effect modification was explored for age at diagnosis. The rate of never smokers increased by 3% per year for newly diagnosed Crohn's disease patients (incidence rate ratio (IRR) 1.03; 95% confidence interval (CI): 1.02-1.05), but not for ulcerative colitis. The rate of surgery decreased among Crohn's disease patients aged 17-40 years (IRR 0.96; 95% CI: 0.93-0.98), but not for ulcerative colitis. Smoking at diagnosis increased the risk of surgery for Crohn's disease patients diagnosed after the age of 40 (hazard ratio (HR) 2.99; 95% CI: 1.52-5.92), but not for those diagnosed before age 40. Ulcerative colitis patients diagnosed between the ages of 17 and 40 years and who quit smoking before their diagnosis were more likely to undergo a colectomy (ex-smoker vs. never smoker: HR 1.66; 95% CI: 1.04-2.66). The age-specific findings were consistent across sensitivity analyses for Crohn's disease, but not ulcerative colitis. In this study, the association of smoking and surgical resection was dependent on the age at diagnosis of IBD.
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descriptionWe assessed the association of smoking at diagnosis of inflammatory bowel disease (IBD) on the need for an intestinal resection. The Health Improvement Network was used to identify an inception cohort of Crohn's disease (n=1519) and ulcerative colitis (n=3600) patients from 1999-2009. Poisson regression explored temporal trends for the proportion of newly diagnosed IBD patients who never smoked before their diagnosis and the risk of surgery within 3 years of diagnosis. Cox proportional hazard models assessed the association between smoking and surgery, and effect modification was explored for age at diagnosis. The rate of never smokers increased by 3% per year for newly diagnosed Crohn's disease patients (incidence rate ratio (IRR) 1.03; 95% confidence interval (CI): 1.02-1.05), but not for ulcerative colitis. The rate of surgery decreased among Crohn's disease patients aged 17-40 years (IRR 0.96; 95% CI: 0.93-0.98), but not for ulcerative colitis. Smoking at diagnosis increased the risk of surgery for Crohn's disease patients diagnosed after the age of 40 (hazard ratio (HR) 2.99; 95% CI: 1.52-5.92), but not for those diagnosed before age 40. Ulcerative colitis patients diagnosed between the ages of 17 and 40 years and who quit smoking before their diagnosis were more likely to undergo a colectomy (ex-smoker vs. never smoker: HR 1.66; 95% CI: 1.04-2.66). The age-specific findings were consistent across sensitivity analyses for Crohn's disease, but not ulcerative colitis. In this study, the association of smoking and surgical resection was dependent on the age at diagnosis of IBD.
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titleThe Association of Smoking and Surgery in Inflammatory Bowel Disease is Modified by Age at Diagnosis
authorFrolkis, Alexandra D ; de Bruyn, Jennifer ; Jette, Nathalie ; Lowerison, Mark ; Engbers, Jordan ; Ghali, William ; Lewis, James D ; Vallerand, Isabelle ; Patten, Scott ; Eksteen, Bertus ; Barnabe, Cheryl ; Panaccione, Remo ; Ghosh, Subrata ; Wiebe, Samuel ; Kaplan, Gilaad G
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abstractWe assessed the association of smoking at diagnosis of inflammatory bowel disease (IBD) on the need for an intestinal resection. The Health Improvement Network was used to identify an inception cohort of Crohn's disease (n=1519) and ulcerative colitis (n=3600) patients from 1999-2009. Poisson regression explored temporal trends for the proportion of newly diagnosed IBD patients who never smoked before their diagnosis and the risk of surgery within 3 years of diagnosis. Cox proportional hazard models assessed the association between smoking and surgery, and effect modification was explored for age at diagnosis. The rate of never smokers increased by 3% per year for newly diagnosed Crohn's disease patients (incidence rate ratio (IRR) 1.03; 95% confidence interval (CI): 1.02-1.05), but not for ulcerative colitis. The rate of surgery decreased among Crohn's disease patients aged 17-40 years (IRR 0.96; 95% CI: 0.93-0.98), but not for ulcerative colitis. Smoking at diagnosis increased the risk of surgery for Crohn's disease patients diagnosed after the age of 40 (hazard ratio (HR) 2.99; 95% CI: 1.52-5.92), but not for those diagnosed before age 40. Ulcerative colitis patients diagnosed between the ages of 17 and 40 years and who quit smoking before their diagnosis were more likely to undergo a colectomy (ex-smoker vs. never smoker: HR 1.66; 95% CI: 1.04-2.66). The age-specific findings were consistent across sensitivity analyses for Crohn's disease, but not ulcerative colitis. In this study, the association of smoking and surgical resection was dependent on the age at diagnosis of IBD.
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pmid27101004
doi10.1038/ctg.2016.21
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