Crohn's Disease in a Southern European Country: Montreal Classification and Clinical Activity

Background: Given the heterogeneous nature of Crohn's disease (CD), Our aim was to apply the Montreal Classification to a large cohort of Portuguese patients with CD in order to identify potential predictive regarding the need for medical and/or Surgical treatment. Methods: A cross-sectional Study was Used based oil data from an on-line registry of patients with CD. Results: Of the 1692 patients with 5 or more years of disease. 747 (44%) were male and 945 (56%) female. Oil multivariate analysis the A2 group was all independent risk factor of the need for steroids (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.1-2.3) and the A I and A2 groups for immunosuppressants (OR 2.2 CI 1.2-3.8: OR 1.4; CI 1.0-2.0. respectively). An L3+L3(4) and L-4 location were risk factors for immunosupression (OR 1.9 CI 1.5-2.4), whereas an L1 location was significantly associated with the need for abdominal surgery (P < 0.001). After 20 years of disease. less than 10% of patients persisted without steroids, immunosupression. or surgery. The Montreal Classification allowed LIS to identify different groups of disease severity: A1 were more immunosuppressed without surgery, most of A2 patients were Submitted to surgery. and 52% of L1+L1(4) patients were operated without immunosuppressants. Conclusions: Stratifying patients according to the Montreal Classification may prove useful in identifying different phenotypes with different therapies and severity. Most of Our patients have severe disease.