Table 2. Demographic, clinical, biochemical, quality of life, healthcare utilization and treatment patterns across Crohn's disease phenotypes defined by Delta Lémann Index.
Improving (A) DLI: < 0 |
Stable (B) DLI: 0 |
Worsening (C) DLI: >0 |
A vs B vs C P value |
A vs C P value |
B vs C P value |
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Patients, n (%) | 38 (15.6) | 75 (30.9) | 130 (53.5) | NA | NA | NA |
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Females, n (%) | 19 (50) | 46 (61.3) | 76 (58.5) | 0.509 | 0.36 | 0.768 |
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Age(y), median (IQR) | 43 (33-52) | 47 (37-61) | 44 (33-54) | 0.06 | 0.706 | 0.037 |
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BMI (kg/m2), median (IQR) | 24.2 (22.7- 28.1) | 26.1 (22.9-30.1) | 25.2 (21.5-28.1) | 0.166 | .919 | 0.071 |
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Smokers, n (%) | 0.368 | 0.239 | 0.440 | |||
Never | 22 (57.9) | 41 (54.7) | 60 (46.5) | |||
Former | 3 (7.9) | 14 (18.7) | 24 (18.6) | |||
Current | 13 (34.2) | 20 (26.7) | 45 (34.9) | |||
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Age at diagnosis (y), median (IQR) | 28.5 (22.5-38.5) | 28 (24-35) | 28.5 (22-40) | 0.898 | 0.956 | 0.648 |
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Disease duration (y), median (IQR) | 10.5 (4.5-16) | 13 (8-26) | 10 (6-18) | 0.029 | 0.547 | 0.021 |
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Disease location, n (%)(18) | ||||||
L1 (ileal) | 5 (13.2) | 22 (29.3) | 30 (23.3) | 0.163 | 0.256 | 0.405 |
L2 (colonic) | 15 (39.5) | 12 (16) | 24 (18.6) | 0.009 | 0.01 | 0.706 |
L3 (ileocolonic) | 18 (47.4) | 41 (54.7) | 75 (57.7) | 0.556 | 0.354 | 0.770 |
L4 (isolated upper digestive) | 0 | 0 | 1 (0.8) | N/A | N/A | N/A |
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Disease behavior, n (%)(18) | ||||||
B1 (non stricturing, non penetrating) | 17 (44.7) | 37 (49.3) | 30 (23.1) | 0.002 | 0.023 | 0.001 |
B2 (stricturing) | 11 (28.9) | 19 (25.3) | 42 (32.3) | 0.035 | 0.264 | 0.017 |
B3 (penetrating) | 5 (13.2) | 13 (17.3) | 30 (23.1) | 0.242 | 0.836 | 0.250 |
P (perianal disease) | 5 (13.2) | 6 (8) | 28 (21.5) | 0.014 | 0.671 | 0.015 |
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CRS prior to study, n (%) | 17 (44.7) | 49 (65.3) | 109 (83.8) | <0.001 | <0.001 | 0.003 |
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CRS during study, n (%) | 4 (10.5) | 12 (16) | 86 (66.2) | <0.001 | <0.001 | <0.001 |
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Psychiatrics co-morbidities, n (%) | 8 (21.1) | 19 (26.8) | 51 (40.8) | 0.029 | 0.034 | 0.063 |
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LI1, median (IQR) | 7.5 (2.3-10.5) | 8.3 (0-10.8) | 8.3 (1.3-12.3) | 0.357 | 0.903 | 0.156 |
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LI2, median (IQR) | 3.5 (0-8.3) | 8.3 (0-10.8) | 13.1 (8.3-31.7) | <0.001 | <0.001 | <0.001 |
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DLI, median (IQR) | -2.3 (-3.2 - -0.6) | 0 | 3.2 (1.2-8.8) | <0.001 | <0.001 | <0.001 |
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Months between LI1 and LI2, median (IQR) | 46.5 (40-54) | 47 (41-52) | 50 (43-56) | 0.095 | 0.193 | 0.041 |
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ESR elevation (/5y), median (IQR) | 1 (0-3) | 1 (0-2) | 1 (0-3) | 0.057 | 0.714 | 0.016 |
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CRP elevation (/5y), median (IQR) | 0.5 (0-2) | 0 (0-1) | 1 (0-2) | <0.001 | 0.03 | <0.001 |
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5y SIBDQ, median (IQR) | 51.5 (44-61) | 53 (44-59) | 47 (39-57) | 0.036 | 0.047 | 0.034 |
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5y HBI, median (IQR) |
3.9 (1.6-7.2) | 5.8 (2-6.2) | 4.8 (2.5-7.5) | 0.299 | 0.313 | 0.153 |
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IBD clinic visits, median (IQR) | 7 (5-13) | 6 (4-9) | 12 (7-19) | <0.001 | 0.006 | <0.001 |
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ED visits, median (IQR) |
0 (0-1) | 1 (0-2) | 2 (0-5) | 0.002 | 0.002 | 0.016 |
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Phone calls to IBD clinic, median (IQR) |
20 (12-28) | 18 (10-28.5) | 32 (15.5-52) | <0.001 | 0.012 | <0.001 |
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Hospitalizations, median (IQR) | 2 (1-3) | 1 (1-3) | 2 (1-4.5) | 0.104 | 0.561 | 0.036 |
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Steroid use (/5y), median (IQR) | 0 (0-2) | 0 (0-1) | 1 (0-3) | 0.001 | 0.114 | <0.001 |
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Immunomodulator use (/5y), median (IQR) | 1.5 (0-4) | 2 (0-5) | 2 (0-4) | 0.583 | 0.317 | 0.909 |
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Anti-TNF use (/5y), median (IQR) | 1.5 (0-4) | 0 (0-2) | 2 (0-3) | 0.009 | 0.818 | 0.002 |
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Anti-depressant use (/5y), median (IQR) | 0 (0-2) | 0 (0-1) | 0 (0-1) | 0.586 | 0.547 | 0.522 |
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Opioid use (/5y), median (IQR) | 0 (0-1) | 0 (0-2) | 1 (0-2) | 0.049 | 0.041 | 0.065 |
n: Number of patients; IQR: Interquartile range; BMI: Body Mass Index; CRS: Crohn's disease related surgery (both outpatient and inpatient); LI1: Lémann Index 1; LI2: Lémann index 2; DLI: Delta Lémann Index; ESR: Erythrocyte sedimentation rate; CRP: C-reactive protein; SIBDQ: Short inflammatory bowel disease questionnaire; HBI: Harvey Bradshaw Index; IBD: Inflammatory bowel disease; ED: Emergency department; TNF: Tumor necrosis factor; y: years; NA: Not applicable