An envirogenomic signature is associated with risk of IBD-related surgery in a population based Crohn’s disease cohort

Nasir, Bushra, Griffith, Lyn R., Nasir, Aslam, Roberts, Rebecca, Barclay, Murray, Gearry, Richard B. and Lea, Rodney A. (2013) An envirogenomic signature is associated with risk of IBD-related surgery in a population based Crohn’s disease cohort. Journal of Gastrointestinal Surgery, 17 9: 1643-1650. doi:10.1007/s11605-013-2250-1

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Author Nasir, Bushra
Griffith, Lyn R.
Nasir, Aslam
Roberts, Rebecca
Barclay, Murray
Gearry, Richard B.
Lea, Rodney A.
Title An envirogenomic signature is associated with risk of IBD-related surgery in a population based Crohn’s disease cohort
Journal name Journal of Gastrointestinal Surgery   Check publisher's open access policy
ISSN 1091-255X
1873-4626
Publication date 2013
Year available 2013
Sub-type Article (original research)
DOI 10.1007/s11605-013-2250-1
Open Access Status File (Author Post-print)
Volume 17
Issue 9
Start page 1643
End page 1650
Total pages 8
Place of publication New York, NY United States
Publisher Springer
Collection year 2013
Language eng
Formatted abstract
Background and Aims:
Crohn's disease (CD) is an inflammatory bowel disease (IBD) caused by a combination of genetic, clinical, and environmental factors. Identification of CD patients at high risk of requiring surgery may assist clinicians to decide on a top-down or step-up treatment approach. Methods: We conducted a retrospective case-control analysis of a population-based cohort of 503 CD patients. A regression-based data reduction approach was used to systematically analyse 63 genomic, clinical and environmental factors for association with IBD-related surgery as the primary outcome variable.

Results: A multi-factor model was identified that yielded the highest predictive accuracy for need for surgery. The factors included in the model were the NOD2 genotype (OR = 1.607, P = 2.3 × 10-5), having ever had perianal disease (OR = 2.847, P = 4 × 10-6), being post-diagnosis smokers (OR = 6.312, P = 7.4 × 10-3), being an ex-smoker at diagnosis (OR = 2.405, P = 1.1 × 10-3) and age (OR = 1.012, P = 4.4 × 10-3). Diagnostic testing for this multi-factor model produced an area under the curve of 0.681 (P = 1 × 10-4) and an odds ratio of 3.169, (95 % CI P = 1 × 10-4) which was higher than any factor considered independently.

Conclusions: The results of this study require validation in other populations but represent a step forward in the development of more accurate prognostic tests for clinicians to prescribe the most optimal treatment approach for complicated CD patients
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Wed, 25 Mar 2015, 13:30:35 EST by Bushra Nasir on behalf of Rural Clinical School