Comparative Study on the Management and Outcomes of Postoperative Crohn's Disease in Older Patients: Data From the ENEIDA Registry
Por:
Maosa, M, Calafat, M, Ricart, E, Nos, P, Iglesias, E, Riestra, S, Mesonero, F, Calvo, M, Guardiola, J, Hernndez, V, Rivero, M, Carpio, D, Mnguez, M, Alba, C, Martn-Arranz, MD, Vela, M, Gomollon, F, Garca-Lopez, S, Casbas, AG, Calvet, X, Gonzlez-Muoza, C, Barrio, J, Gisbert, JP, Sicilia, B, Prez-Calle, JL, Bujanda, L, Esteve, M, Ramos, L, Varela, P, Sierra, M, Merino, O, Bermejo, F, Barreiro-de Acosta, MB, Perez, AR, Mrquez-Mosquera, L, Garca-Bosch, O, Rodrguez-Lago, I, Poyatos, RHL, Sepulcre, MFG, Maroto, N, Vega, P, Monfort, D, San Martn, LZ, Busquets, D, Martinez-Montiel, P, Riera, J, Alcain, G, Llao, J, Marin, N, Marin-Jimenez, I, Ses, E, Van Domselaar, M, Huguet, JM, Ginard, D, Bas-Cutrina, F, Ber, Y, Roncero, O, Lucendo, AJ, Lopez-Garca, A, Menacho, M, Almela, P, Ponferrada, A, Coronel, AF, Maestro, S, Martnez-Prez, TD, Vilafranca, CM, Argelles, F, Legido, J, Gilabert, P, Charro, M, Trapero, AM, Fernndez, H, Frago, S, Villalba, LH, Muoz, E, Domnech, E
Publicada:
1 feb 2026
Ahead of Print:
1 dic 2025
Resumen:
Background: Limited data are available on the management and outcomes of postoperative Crohn's disease (CD) in older patients. We aimed to describe the management of CD in the postoperative setting and assess surgical postoperative recurrence (POR) in this population. Methods: This was a case-control study including all adult patients with CD from the ENEIDA registry who had undergone a first intestinal resection with ileo-colonic anastomosis. Patients were grouped according to their age at the time of the first surgery in older (over 60 years) subjects and controls (between 18 and 60 years of age). Results: A total of 3982 (535 older subjects and 3454 controls) underwent a first intestinal resection for CD with an ileo-colonic anastomosis. Time from CD diagnosis to surgery was significantly longer in older patients (114 +/- 128 vs. 93 +/- 97 months; p < 0.001). Older patients also had a lower proportion of penetrating CD (25% vs. 39%; p < 0.0001) and perianal disease (14% vs. 25%; p < 0.0001). A significantly lower proportion of older patients started preventive therapies for POR (32% vs. 51%; p < 0.0001). The cumulative risk of surgical POR was 3.2%, 5.3% and 10.1% in the older group and 3.6%, 6.6% and 14.2% in the control group at three, five and 10 years, respectively (p = 0.093). In the multivariate logistic regression analysis, only prevention with thiopurines was associated with a lower risk of surgical POR. Conclusions: Although postoperative preventive therapy with immunomodulators or biologicals is prescribed less often in older patients after a first intestinal resection, they develop surgical POR as often as younger adult patients.
Filiaciones:
Maosa, M:
Hosp Badalona Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Calafat, M:
Hosp Badalona Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Ricart, E:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Hosp Clin Barcelona, IDIBAPS, Dept Gastroenterol, Barcelona, Spain
Nos, P:
Hosp Univ i Politecn La Fe, Dept Gastroenterol, Valencia, Spain
Iglesias, E:
Univ Cordoba UCO, Hosp Univ Reina Sofia, Dept Gastroenterol, IMIBIC, Cordoba, Spain
Riestra, S:
Hosp Univ Cent Asturias, Dept Gastroenterol, Inst Invest Sanitaria Principado Asturias ISPA, Oviedo, Spain
Mesonero, F:
Hosp Univ Ramon & Cajal, Dept Gastroenterol, Madrid, Spain
Calvo, M:
Hosp Univ Puerta Hierro Majadahonda, Dept Gastroenterol, Majadahonda, Spain
Guardiola, J:
Hosp Univ Bellvitge, Dept Gastroenterol, Lhospitalet De Llobregat, Barcelona, Spain
Hernndez, V:
Hosp Alvaro Cunqueiro, Inst Invest Sanitaria Galicia, Dept Gastroenterol, Vigo, Spain
Rivero, M:
Hosp Univ Marques Valdecilla, Dept Gastroenterol, Inst Invest IDIVAL, Santander, Spain
Carpio, D:
Complexo Hosp Univ Pontevedra, Dept Gastroenterol, Pontevedra, Spain
Mnguez, M:
Hosp Clin Univ Valencia, Dept Gastroenterol, Valencia, Spain
Alba, C:
Hosp Clin San Carlos, Dept Gastroenterol, Madrid, Spain
Martn-Arranz, MD:
Hosp Univ La Paz, Dept Gastroenterol, Madrid, Spain
Vela, M:
Hosp Univ Nuestra Senora de la Candelaria, Dept Gastroenterol, Santa Cruz De Tenerife, Spain
Gomollon, F:
Hosp Clin Univ Lozano Blesa, Dept Gastroenterol, Zaragoza, Spain
Garca-Lopez, S:
Hosp Univ Miguel Servet, Dept Gastroenterol, Zaragoza, Spain
Casbas, AG:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Hosp Gen Univ Alicante, ISABIAL, Dept Gastroenterol, Alicante, Spain
Calvet, X:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Univ Autonoma Barcelona, Hosp Univ Parc Tauli Sabadell, Inst Invest & Innovacio Parc Tauli I3PT CERCA, Dept Gastroenterol, Sabadell, Spain
Gonzlez-Muoza, C:
Hosp Santa Creu i St Pau, Dept Pulmonol, Barcelona, Spain
Barrio, J:
Hosp Univ Rio Hortega, Dept Gastroenterol, Valladolid, Spain
Gisbert, JP:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Univ Autonoma Madrid UAM, Hosp Univ La Princesa, Dept Gastroenterol, Inst Invest Sanitaria Princesa IIS Princesa, Madrid, Spain
Sicilia, B:
Hosp Univ Burgos, Dept Gastroenterol, Burgos, Spain
Prez-Calle, JL:
Hosp Univ Fdn Alcorcon, Dept Gastroenterol, Alcorcon, Spain
Bujanda, L:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Univ Pais Vasco UPV EHU, Donostia Univ Hosp, Biodonostia Hlth Res Inst, Dept Gastroenterol, San Sebastian, Donostia, Spain
Esteve, M:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Hosp Univ Mutua Terrassa, Dept Gastroenterol, Terrassa, Spain
Ramos, L:
Hosp Univ Canarias, Dept Gastroenterol, San Cristobal la Laguna, Spain
Varela, P:
Hosp Univ Cabuenes, Dept Gastroenterol, Gijon, Spain
Sierra, M:
Complejo Asistencial Univ Leon, Dept Gastroenterol, Leon, Spain
Merino, O:
Hosp Univ Cruces, Dept Gastroenterol, Baracaldo, Spain
Bermejo, F:
Inst Invest Hosp Univ La Paz IdiPAZ, Hosp Univ Fuenlabrada, Dept Gastroenterol, Fuenlabrada, Spain
Barreiro-de Acosta, MB:
Hosp Clin Univ Santiago, Dept Gastroenterol, Santiago De Compostela, Spain
Perez, AR:
Hosp Univ Salamanca, Dept Gastroenterol, Salamanca, Spain
Mrquez-Mosquera, L:
Hosp Mar, Dept Gastroenterol, Barcelona, Spain
Garca-Bosch, O:
Hosp Moises Broggi, Dept Gastroenterol, Sant Joan Despi, Spain
Rodrguez-Lago, I:
Hosp Univ Galdakao, Dept Gastroenterol, Galdakao, Spain
Poyatos, RHL:
Hosp Gen Univ Ciudad Real, Dept Gastroenterol, Ciudad Real, Spain
Sepulcre, MFG:
Hosp Gen Univ Elche, Dept Gastroenterol, Elche, Spain
Maroto, N:
Hosp Manises, Dept Gastroenterol, Manises, Spain
Vega, P:
Complejo Hosp Univ Ourense, Dept Gastroenterol, Orense, Spain
Monfort, D:
Consorci Sanit Terrassa, Dept Gastroenterol, Terrassa, Spain
San Martn, LZ:
Hosp Univ Navarra, Dept Gastroenterol, Pamplona, Spain
Busquets, D:
Hosp Girona Doctor Josep Trueta, Dept Gastroenterol, Girona, Spain
Martinez-Montiel, P:
Hosp Univ 12 Octubre, Dept Gastroenterol, Madrid, Spain
Riera, J:
Hosp Univ Son Llatzer, Dept Dermatol, Palma De Mallorca, Baleares, Spain
Alcain, G:
Hosp Virgen Victoria, Dept Gastroenterol, Malaga, Spain
Llao, J:
Althaia Xarxa Assistencial Univ Manresa, Dept Gastroenterol, Manresa, Spain
Marin, N:
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Marin-Jimenez, I:
Univ Complutense Madrid, Hosp Gen Univ Gregorio Maranon, Dept Gastroenterol, Inst Invest Sanitaria Gregorio Maranon IiSGM, Madrid, Spain
Ses, E:
Hosp Univ Arnau Vilanova Lleida, Dept Gastroenterol, Lleida, Spain
Van Domselaar, M:
Hosp Univ Torrejon, Dept Gastroenterol, Torrejon De Ardoz, Spain
Huguet, JM:
Consorcio Hosp Gen Univ Valencia, Dept Gastroenterol, Valencia, Spain
Ginard, D:
Hosp Univ Son Espases, Dept Gastroenterol, Palma De Mallorca, Spain
Bas-Cutrina, F:
Hosp Gen Granollers, Dept Gastroenterol, Granollers, Spain
Ber, Y:
Hosp San Jorge, Dept Gastroenterol, Huesca, Spain
Roncero, O:
Complejo Hosp La Mancha Ctr, Dept Gastroenterol, Alcazar De San Juan, Spain
Lucendo, AJ:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Hosp Gen Tomelloso, Dept Gastroenterol, Tomelloso, Spain
Lopez-Garca, A:
Hosp Univ Infanta Sofia, Dept Gastroenterol, San Sebastian De Reyes, Spain
Menacho, M:
Hosp Univ Joan XXIII, Dept Gastroenterol, Tarragona, Spain
Almela, P:
Hosp Gen Univ Castellon, Dept Gastroenterol, Castellon de La Plana, Spain
Ponferrada, A:
Hosp Univ Infanta Leonor, Dept Gastroenterol, Madrid, Spain
Coronel, AF:
Complejo Asistencial Zamora, Dept Gastroenterol, Zamora, Spain
Maestro, S:
Complejo Asistencial Univ Palencia, Dept Gastroenterol, Palencia, Spain
Martnez-Prez, TD:
Hosp Virgen de La Luz, Dept Gastroenterol, Cuenca, Spain
Vilafranca, CM:
Hosp Univ Basurto, Dept Gastroenterol, Bilbao, Spain
Argelles, F:
Univ Seville, Hosp Univ Virgen Macarena, Dept Gastroenterol, Seville, Spain
Legido, J:
Complejo Asistencial Segovia, Dept Gastroenterol, Segovia, Spain
Gilabert, P:
Hosp Viladecans, Dept Gastroenterol, Viladecans, Spain
Charro, M:
Hosp Royo Villanova, Dept Gastroenterol, Zaragoza, Spain
Trapero, AM:
Complejo Hosp Jaen, Dept Gastroenterol, Jaen, Spain
Fernndez, H:
Hosp San Pedro, Dept Gastroenterol, Logrono, Spain
Frago, S:
Hosp Santa Barbara, Dept Gastroenterol, Soria, Spain
Villalba, LH:
Hosp Santos Reyes, Dept Gastroenterol, Aranda De Duero, Spain
Muoz, E:
Hosp Vega Baja, Dept Gastroenterol, Orihuela, Spain
Domnech, E:
Hosp Badalona Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain
Green Submitted, hybrid
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