| Abstract [eng] |
Introduction. Inflammatory bowel diseases are chronic systemic conditions that can affect not only the gastrointestinal tract but also other organ systems. Inflammatory processes that occur outside the gut are known as extraintestinal manifestations. These manifestations can significantly complicate the course of the disease and reduce patients’ quality of life. The reported prevalence of extraintestinal manifestations varies widely, ranging from 6 % to 50 %. Although extraintestinal manifestations have been widely studied internationally, comprehensive epidemiological data on their prevalence in Lithuania remain limited. Aim. To assess the prevalence of extraintestinal manifestations and their associations with demographic and clinical factors among patients with inflammatory bowel diseases treated at Vilnius University Hospital Santaros Clinics between 2013 and 2023. Objectives. 1) To determine the prevalence of extraintestinal manifestations in patients with Crohn’s disease and ulcerative colitis; 2) To identify the most common types of extraintestinal manifestations among patients with inflammatory bowel diseases; 3) To evaluate the associations between extraintestinal manifestations and patient characteristics such as age, sex, follow-up duration, type and subtype of inflammatory bowel disease; 4) To assess the relationship between extraintestinal manifestations and the use of healthcare services. Methods. A retrospective cohort study was conducted. Data were collected by reviewing medical records of patients treated at Vilnius University Hospital Santaros Clinics from 2013 to 2023. The study included patients aged 18 years and older who had been diagnosed with Crohn’s disease or ulcerative colitis and had a follow-up period of at least one year. Statistical analysis was carried out using the R software. Student’s t-test, Mann–Whitney–Wilcoxon test, Pearson’s chi-square test, and Fisher’s exact test were used to compare patient groups. Binary logistic regression analysis was performed to identify associations between extraintestinal manifestations and both clinical and demographic factors. Results. A total of 1016 patients were included in the study: 292 (28.7 %) with Crohn’s disease and 724 (71.3 %) with ulcerative colitis. At least one extraintestinal manifestation was observed in 92 (9.1 %) patients. Extraintestinal manifestations were significantly more common among patients with Crohn’s disease (p < 0.001), women (p = 0.033), and those with a longer follow-up duration (p < 0.001). Musculoskeletal manifestations were the most common, observed in 7.1 % of all patients. Cutaneous, hepatobiliary, and ocular manifestations were less common, occurring in 1.2 %, 0.9 %, and 0.4 % of all patients, respectively. The most frequent individual manifestation was enteropathic arthropathy, diagnosed in 5.9 % of all patients, and significantly more prevalent in Crohn’s disease than in ulcerative colitis (p < 0.001). Logistic regression analysis revealed significant associations between extraintestinal manifestations and female sex (OR=1.63, p = 0.033), Crohn’s disease (OR = 2.27, p < 0.001), the enterocolitis subtype (OR = 2.90, p < 0.001), and longer follow-up duration (OR = 1.12, p = 0.006). Conclusions. 1) The prevalence of extraintestinal manifestations among patients with inflammatory bowel diseases was 9.1 %, and was higher in Crohn’s disease (14.7 %) compared to ulcerative colitis (6.8 %); 2) Musculoskeletal manifestations were the most common, particularly enteropathic arthropathy; 3) Extraintestinal manifestations were significantly associated with female sex, Crohn’s disease, enterocolitis subtype, and longer follow-up duration; 4) The presence of extraintestinal manifestations was related to increased use of healthcare services, including more frequent outpatient consultations, a greater number of hospitalizations, and longer periods of clinical monitoring. |
