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Background <p>Most patients with Crohn’s disease (CD) experience disease progression and will eventually undergo surgery. However, the risks of progression and surgery exhibit significant regional heterogeneity. We conducted a cohort study to explore the risks and associated factors for disease progression, surgery, and postoperative recurrence in CD patients from Yunnan, a plateau province in southwestern China, and compared these data with data from Asian and Western countries.</p> Methods <p>In this study, data from a multicentre cohort from Yunnan Province were collected and analyzed. The cumulative risks of disease progression, surgery, and postoperative recurrence were analyzed. Univariate and multivariate analyses were performed to explore the independent risk factors associated with these outcomes. Finally, the distinct clinical profile of CD in our Yunnan cohort was compared with those of populations in Asian and Western countries, as reported in the literature.</p> Results <p>Among 252 patients with CD, disease behaviour and location progressed in 19.87% and 16.67% of the cohort, respectively. A total of 42.9% of the patients underwent surgery. The cumulative risk of postoperative recurrence at 3&#xa0;years after primary surgery was 53.8%. Intestinal complications (HR = 2.798; <i>P</i> &lt; 0.001) were independent risk factors for primary surgery, whereas the use of glucocorticoids (HR = 0.411; <i>P</i> = 0.002) and the use of biologics (HR = 0.300; <i>P</i> &lt; 0.001) were protective factors. A delayed diagnosis (&gt; 1&#xa0;year) was an independent risk factor for reresection and postoperative recurrence. The cumulative risk of progression of disease behaviour was 34.5% at 5&#xa0;years in Yunnan CD patients, which was greater than those reported in Western (14–15%) and Asian countries (15–30.7%). Similarly, the cumulative risk of surgery was 36.1% at 5&#xa0;years, which exceeded the risks observed in the Western (17.4–35.1%) and Asian (10.7–16.5%) cohorts.</p> Conclusion <p>Compared with those in Asian and Western countries, CD patients in Yunnan exhibit an increased propensity for disease progression and surgical intervention. Intestinal complications and delayed diagnosis (&gt; 1&#xa0;year) are risk factors for surgery and postoperative recurrence.</p>

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More severe natural course of Crohn’s disease in Yunnan province compared with Asian and Western countries

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月3日

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  • Yan Tao,
  • Maojuan Li,
  • Hongna Li,
  • Zhihong Sun,
  • Jing Wu,
  • Li Yang,
  • Yingrui Ma,
  • Xiaoqiang Chen,
  • Lifang Chen,
  • Hao Liang,
  • Yunling Wen,
  • Yinglei Miao,
  • Fengrui Zhang,
  • Junkun Niu

摘要

Background

Most patients with Crohn’s disease (CD) experience disease progression and will eventually undergo surgery. However, the risks of progression and surgery exhibit significant regional heterogeneity. We conducted a cohort study to explore the risks and associated factors for disease progression, surgery, and postoperative recurrence in CD patients from Yunnan, a plateau province in southwestern China, and compared these data with data from Asian and Western countries.

Methods

In this study, data from a multicentre cohort from Yunnan Province were collected and analyzed. The cumulative risks of disease progression, surgery, and postoperative recurrence were analyzed. Univariate and multivariate analyses were performed to explore the independent risk factors associated with these outcomes. Finally, the distinct clinical profile of CD in our Yunnan cohort was compared with those of populations in Asian and Western countries, as reported in the literature.

Results

Among 252 patients with CD, disease behaviour and location progressed in 19.87% and 16.67% of the cohort, respectively. A total of 42.9% of the patients underwent surgery. The cumulative risk of postoperative recurrence at 3 years after primary surgery was 53.8%. Intestinal complications (HR = 2.798; P < 0.001) were independent risk factors for primary surgery, whereas the use of glucocorticoids (HR = 0.411; P = 0.002) and the use of biologics (HR = 0.300; P < 0.001) were protective factors. A delayed diagnosis (> 1 year) was an independent risk factor for reresection and postoperative recurrence. The cumulative risk of progression of disease behaviour was 34.5% at 5 years in Yunnan CD patients, which was greater than those reported in Western (14–15%) and Asian countries (15–30.7%). Similarly, the cumulative risk of surgery was 36.1% at 5 years, which exceeded the risks observed in the Western (17.4–35.1%) and Asian (10.7–16.5%) cohorts.

Conclusion

Compared with those in Asian and Western countries, CD patients in Yunnan exhibit an increased propensity for disease progression and surgical intervention. Intestinal complications and delayed diagnosis (> 1 year) are risk factors for surgery and postoperative recurrence.