Geographic Differences in the Risk of Surgery in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
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2021-11-15
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Abstract
Crohn’s disease (CD) and ulcerative colitis (UC), collectively known as the inflammatory bowel diseases (IBD), are chronic immune mediated conditions. The pathophysiology of these disease is not well understood but genetic predisposition, dietary and microbiome-related factors, and environment exposures have been previously implicated. These diseases have traditionally been thought of as diseases of Caucasians living in the Western world: North America, Europe, and Oceania. However, the incidence of these diseases has been increasing in newly industrialized countries in Asia, Africa, and Latin America. In the Western world, a large proportion of healthcare spending related to IBD management has been on biologic agents.These biologic agents are very costly and are thought to decrease the risk of surgery. The risks of surgery among patients with IBD in the Western world is well described. However, the risks of IBD surgery in Asian countries has not been well assessed. Therefore, the aim of this thesis is to determine the risk of IBD surgery among persons in Asia compared to persons living in Western countries.A systematic review was conducted to identify all population-based studies reportingrisk of IBD surgery for Crohn’s disease or ulcerative colitis among inception cohorts diagnosed in the year 1999 or later. A meta-analysis was performed to pool the risk of surgery for Western and Asian countries. Choropleth maps were generated to highlight regional differences in surgery risk (https://arcg.is/5r48K).
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Hansen, T. (2021). Geographic Differences in the Risk of Surgery in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.