Crohn's disease activity index and Vienna classification - Is it worthwhile to calculate before surgery?

Background: Crohn's disease (CD) patients with increased disease
activity may reveal an increased risk for perioperative
complications. The `Crohn's disease activity index' (CDAI) and the
`Vienna classification' (VC) were developed for standardized
disease activity estimations. The significance of these scores to
predict extent, type and early outcome of surgery in CD patients
was analyzed. Methods: In 179 surgically treated CD patients, the
CDAI and VC were assessed from a prospective database. Relations of
the scores with CD risk factors, type, number, location and
complications of surgery were analyzed. Results: VC behavior and
location subtypes were associated with distinct types of surgery
(i.e. `strictureplasty' in `stricturing disease', `colon surgery'
in `colon involvement'), but not with surgery type and extent or
outcome. Surgery extent (i.e. with 5 vs. 3 `surgical sites' 425 +/-
25 vs. 223.3 +/- 25) and complications (357.1 +/- 36.9 (with) vs.
244.4 +/- 13 (without)) were associated with elevated CDAI levels;
however, nicotine abuse remained the only significant risk factor
for perioperative complications after multiple logistic regression.
Conclusion: The significance of VC or CDAI for predicting the
extent of surgery or complications is limited. None of the tested
variables except preoperative nicotine abuse influenced the
likelihood for perioperative complications. Copyright (c) 2006 S.
Karger AG, Basel