Scientific paperCrohn's disease patients who quit smoking have a reduced risk of reoperation for recurrence
Section snippets
Sample
Our target population consisted of all living CD patients in our computer database whom had undergone an operation (resection [94%], strictureplasty, or bypass) for ileocecal CD and had been followed up for at least 2 years. Medical records and mailing address were available for the 584 CD patients who met the inclusion criteria. We distributed questionnaires and, when possible, interviewed these patients over 3 months. The study was approved by both the Institutional Review Board Human
Results
Two hundred and sixty-seven of 584 patients completed the questionnaire (response rate of 46%). The mean follow-up for the 267 respondents was 18.73 years (range 2 to 59).
Smoking had a statistically significant impact on reoperation rates (Table 1, Table 2). Smokers had an increased risk of one, two and three reoperations for recurrence at any site (Table 1 and Fig. 1) and an increased risk of one reoperation for recurrent ileocecal CD (Table 2 and Fig. 2). The separate analysis including
Comments
These data demonstrate a significant impact of active smoking on reoperation rates for CD. Patients who actively smoke are not only more likely to have a reoperation for recurrent disease but they are more likely to have multiple and additional operations [13], [14]. We did not establish a dose-response relationship. Moreover, there is no apparent impact of smoking on Crohn's disease after subtotal colectomy and ileostomy [15]. Nevertheless, smoking is an important predictive factor for
Acknowledgements
Data collection was done at the University Hospital Birmingham NHS Trust, Birmingham, England. William Ryan performed the data analysis and manuscript composition at Stanford University School of Medicine, Stanford, California, under the supervision of Drs. Allan and Keighley. Catherine Ley, PhD, of the Department of Health Research and Policy at Stanford University, supervised the statistical analysis. A grant from the Stanford University Medical Student Travel Scholars Program helped to fund
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