Table 3.
Factors Associated with Behavioral Progression, Intestinal Resection, and Hospitalization, Excluding Events That Occurred within 6 Months of Diagnosis
| Factor | Risk of behavioral progression (n=316) | Risk of intestinal resection (n=370) |
Risk of hospitalization (n=299) |
|||||
|---|---|---|---|---|---|---|---|---|
| Unadjusted HR (95% CI) | Adjusted HR (95% CI)† | Unadjusted HR (95% CI) | Adjusted HR (95% CI)‡ |
Unadjusted HR (95% CI) | Adjusted HR (95% CI)§ |
|||
| Sex | ||||||||
| Male | Reference | Not included | Reference | Not included | Reference | Not included | ||
| Female | 0.81 (0.49–1.33) | 0.67 (0.36–1.25) | 0.98 (0.61–1.57) | |||||
| Age at diagnosis, yr | ||||||||
| ≤16 (A1) | Reference | Not included | Reference | Not included | Reference | Not included | ||
| 17–40 (A2) | 1.21 (0.69–2.11) | 1.15 (0.57–2.33) | 0.61 (0.36–1.02) | |||||
| >40 (A3) | 0.56 (0.19–1.68) | 0.68 (0.18–2.51) | 0.49 (0.21–1.18) | |||||
| Symptom onset to diagnosis (per mo) |
1.00 (1.00–1.01) | Not included | 1.00 (1.00–1.01) | Not included | 1.00 (1.00–1.01) | Not included | ||
| Cohort | ||||||||
| 1986–2003 | Reference | Reference | Reference | Reference | Reference | Reference | ||
| 2004–2015 | 0.50 (0.33–0.76) | 0.50 (0.33–0.77)* | 0.41 (0.240–0.70) | 0.49 (0.28–0.85)* | 0.45 (0.30–0.68) | 0.51 (0.33–0.79)* | ||
| Current smoking at diagnosis | ||||||||
| No | Reference | Not included | Reference | Reference | Reference | Reference | ||
| Yes | 1.30 (0.83–2.02) | 1.56 (0.94–2.57) | 1.36 (0.82–2.28) | 1.51 (0.99–2.29) | 1.27 (0.82–1.95) | |||
| Family history of IBD | ||||||||
| No | Reference | Reference | Reference | Reference | Reference | Not included | ||
| Yes | 2.07 (1.13–3.79) | 2.01 (1.10–3.70)* | 1.91 (0.94–3.87) | 1.96 (0.95–4.03) | 1.00 (0.49–2.08) | |||
| Disease location at diagnosis | ||||||||
| Colon (L2) | Reference | Not included | Reference | Not included | Reference | Not included | ||
| Ileum (L1) | 1.91 (0.73–5.00) | 3.49 (0.99–12.30) | 1.10 (0.48–2.49) | |||||
| Ileocolon (L3) | 2.22 (0.97–5.12) | 3.08 (0.96–9.95) | 1.12 (0.54–2.32) | |||||
| Upper GI involvement (L4) | ||||||||
| No | Reference | Not included | Reference | Not included | Reference | Not included | ||
| Yes | 0.64 (0.36–1.13) | 0.66 (0.33–1.33) | 0.84 (0.51–1.41) | |||||
| Disease behavior at diagnosis | ||||||||
| Nonstricturing, nonpenetrating (B1) | - | - | Reference | Reference | Reference | Reference | ||
| Stricturing (B2) | - | - | 2.44 (1.23–4.82) | 2.18 (1.09–4.35)* | 2.37 (1.34–4.21) | 2.24 (1.25–3.99)* | ||
| Penetrating (B3) | - | - | 3.42 (1.46–8.03) | 4.93 (2.02–12.08)* | 3.62 (1.31–10.00) | 2.88 (1.02–8.18)* | ||
| Perianal fistula before or at diagnosis | ||||||||
| No | Reference | Not included | Reference | Not included | Reference | Not included | ||
| Yes | 1.03 (0.68–1.55) | 0.88 (0.54–1.44) | 0.87 (0.58–1.30) | |||||
| Early use of corticosteroids | 0.90 (0.59–1.37) | Not included | 1.06 (0.65–1.73) | Not included | 0.81 (0.53–1.26) | Not included | ||
| Early use of thiopurines | 0.77 (0.47–1.25) | Not included | 0.46 (0.23–0.94) | 0.47 (0.22–1.01) | 0.53 (0.32–0.89) | 0.67 (0.39–1.16) | ||
| Early use of anti-TNF agents | 0.53 (0.13–2.16) | Not included | 0.55 (0.08–3.97) | Not included | 0.05 (0.00–10.13) | Not included | ||
HR, hazard ratio; CI, confidence interval; IBD, inflammatory bowel disease; GI, gastrointestinal; TNF, tumor necrosis factor.
*p<0.05; †Model included the following covariates: cohort (1986–2003 or 2004–2015), and family history of IBD; ‡Model included the following covariates: cohort (1986–2003 or 2004–2015), current smoking at diagnosis, family history of IBD, disease behavior at diagnosis, and early use of thiopurines; §Model included the following covariates: cohort (1986–2003 or 2004–2015), current smoking at diagnosis, disease behavior at diagnosis, and early use of thiopurines.