Clinical outcome of Crohn's disease: Analysis according to the Vienna Classification and clinical activity

The aim of this study was to describe the clinical course of Crohn's diseas e (CD) in a well-defined, homogeneous groups of patients. A total of 480 pa tients with CD were followed up from diagnosis up to 20 years. Definitions of patient subgroups were made according to the Vienna Classification. Mark ov chain analysis was used to estimate the probabilities of remissions and relapses during the disease course. Both age at diagnosis and behavior were associated with different disease locations. Patients with ileal disease h ad a greater need for surgical and a lesser need for immunosuppressive trea tment; patients with ileocolonic disease were diagnosed at an earlier age a nd showed a lower probability of remaining in remission during the disease course; patients with colonic disease needed less surgical or steroid treat ments; patients with intestinal penetrating disease were frequently submitt ed to abdominal surgery, whereas those with anal-penetrating disease often needed immunosuppressive treatment. Approximately 40% of the patients were in clinical remission at any time, but only about 10% maintained a long-ter m remission free of steroids after their initial presentation. A more benig n clinical course could be predicted in patients who stay in remission in t he year after diagnosis. The grouping of patients with CD according to the Vienna Classification and/or the clinical activity in the year after diagno sis is useful in predicting the subsequent course of disease.