CLASSIFICATION OF THE SEQUELAE OF BOWEL RESECTION FOR CROHNS-DISEASE

A postoperative handicap index designed to predict diarrhoea and malnu trition following bowel resection in patients with Crohn's disease is proposed. The index takes into account the location and extent of rese ction, and its value can be calculated from operative records. Retrosp ective (n = 218) and prospective (n = 68) series of patients were stud ied. Diarrhoea and malnutrition developed in 102 patients (47 per cent ) and 13 patients (6 per cent) respectively in the retrospective serie s, and in 40 (59 per cent) and one (1 per cent) of those in the prospe ctive series. The handicap index correlated with faecal weight and fae cal fat in 112 patients tested. Positive and negative predictive value s of an index score greater than 20 for the development of diarrhoea, and over 50 for the development of malnutrition, were 0.64 and 0.90, a nd 0.60 and 0.99 respectively in the retrospective series; values were 0.80 and 0.71, and 0.25 and 1.00 in the prospective series. The posto perative handicap index is a useful tool for predicting the functional consequences of bowel resection for Crohn's disease.