Table 2.
Trends in surgery rates in Canadian people with Crohn’s disease and ulcerative colitis
| Study | Province | Years | Age group | Type of cohort | Type of IBD | Surgery rates | Time trend (95% CI) |
|---|---|---|---|---|---|---|---|
| Dittrich et al. (10) | Alberta (Edmonton) | 1996–2013 | Adults (≥18 years) | Prevalent | CD | 1996: 5.8 per 100 patients 2013: 1.4 per 100 patients |
AAPC: −8.4% (−9.6, −7.3) |
| El-Matary et al. (9) | Manitoba | 1995–2017 | Paediatrics | Incident | IBD | 1995–2003: 5.2 per 100 PY 2004–2017: 1.8 per 100 PY |
RR: 0.34 (0.20, 0.59) |
| Targownik et al. (1) | Manitoba | 2005–2015 | All ages | Prevalent | CD | 2005: 1.88 per 100 PY 2015: 1.27 per 100 PY |
AAPC: −3.6% (−6.0, −1.2) |
| Prevalent | UC | 2005: 0.85 per 100 PY 2015: 0.83 per 100 PY |
AAPC: 1.7% (−2.0, 5.4) | ||||
| Dheri et al. (3) | Ontario | 1994–2012 | Paediatrics (<18 years) | Incident | CD | — | AAPC: −6.0% (−7.3, −4.6) |
| UC | — | AAPC: −3.0% (−5.2, −0.7) | |||||
| Murthy et al. (4) | Ontario | 1995–2012 | Adults (>18 years) | Prevalent | CD | — | Pre-infliximab: OR:† 0.984 (0.975, 0.99) Post-infliximab: OR:† 1.10 (0.81, 1.50) |
| UC | — | Pre-infliximab: OR:† 0.993 (0.975, 1.01) Post-infliximab: OR:† 0.933 (0.540, 1.61) |
|||||
| Rahman et al. (2) | Ontario | 2003–2014 | All ages | Prevalent | CD | All inpatient surgeries: 2003: 53 (95% CI: 50, 55) per 1000 2014: 32 (95% CI: 30, 34) per 1000 Intestinal resections: 2003: 41 (95% CI: 39, 43) per 1000 2014: 23 (95% CI: 22, 25) per 1000 All outpatient surgeries:* 2003: 8 (95% CI: 7, 9) per 1000 2014: 12 (95% CI: 10, 13) per 1000 |
All inpatient surgeries: 39.6% decrease over the course of the study Intestinal resections: 44% decrease over the course of the study |
| Khalil et al. (13) | Québec | 1998–2011 | Not stated | Prevalent | UC | 1998–2004: 36 per 1000 PY 2005–2011: 30 per 1,000 PY |
HR:‡ 0.81 (0.70, 0.95) |
| Verdon et al. (6) | Québec | 1996–2015 | Not stated | Incident (proportion with surgery within five years of diagnosis) | CD | 1st surgeries: 1996–2010: 8% 2011–2015: 15% 2nd surgeries: 1996–2010: 18% 2011–2015: 21% |
— |
| UC | 1996–2010: 6% 2011–2015: 10% |
— |
Abbreviations: AAPC, Average annual percentage change; , Confidence interval; IBD, Inflammatory bowel disease; OR, Odds ratio; PY, Person-years; RR, Relative risk; UC, Ulcerative colitis.
*Includes stricture dilations and stricturoplasty (61.6% in 2014) and fistula or perianal surgeries (36.9% in 2014).
†Quarter analyzed as a continuous variable; odds ratio (OR) compares the odds of hospitalization per quarter change in time.
‡Comparing across eras.