INTESTINAL AND EXTRAINTESTINAL COMPLICATIONS OF CROHNS-DISEASE - PREDICTORS AND CUMULATIVE PROBABILITY OF COMPLICATIONS

Of 238 patients with Crohn's disease seen at our clinics from April 19 73 to August 1988, 203 patients were selected for this study, since th ey fulfilled the following criteria: they had been followed up for mor e than 6 months as outpatients or had been treated as inpatients for m ore than 1 month. They were studied to elucidate: (a) the different ty pes and incidence of various complications, (b) the factors related to complications present at the time of diagnosis, (c) predictors of new complications arising after diagnosis, and (d) the cumulative inciden ce of complications occurring during the course of the disease from th e times of onset and diagnosis. Of the intestinal complications, peria nal fistula was most common (33%), followed by strictures with dilatat ions of the proximal bowel (21%), and internal fistula (14%). Of the e xtraintestinal complications, menstrual disturbance was the most commo n (18% of the female patients), followed by arthritis (10%), and aphth ous stomatitis (10%). As for the factors influencing complications pre sent at the time of diagnosis, the pattern of bowel involvement was si gnificantly correlated with the presence of intestinal stricuture, whi le the erythrocyte sedimentation rate was significantly correlated wit h the presence of perianal fistula. A significant predictor of new com plications arising after diagnosis was the general well-beling of pati ents at the time of diagnosis. Patients who, at diagnosis, already hav e complications such as stricture, abdominal abscess, internal or exte rnal fistula, massive hemorrhage, and free perforation or anal lesions are more likely to develop new complications in addition to those pre sent at diagnosis, compared with patients without any complications at diagnosis (P = 0.055).