Clinical characterization of patients with anal fistula during follow-up of anorectal abscess : a large population-based study
Sanchez-Haro, Edward (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vela, Emili (Àrea de Sistemes d'informació, Servei Català de la Salut (CatSalut))
Cleries, Montserrat (Àrea de Sistemes d'informació, Servei Català de la Salut (CatSalut))
Vela Bernal, Sandra (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Tapiolas, Ingrid (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Troya, José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Julian Ibañez, Joan Francesc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Parés, David (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona. Departament de Cirurgia

Date:	2023
Abstract:	Approximately 15-50% of patients with an anorectal abscess will develop an anal fistula, but the true incidence of this entity is currently unknown. The aim of the study was to determine the incidence of anorectal abscess and development of a fistula in a specific population area and to identify potential risk factors associated with demographic, socioeconomic and pre-existing disease (e. g. diabetes and inflammatory bowel disease). A longitudinal observational study was designed including a large cohort study in an area with 7,553,650 inhabitants in Spain 1st january 2014 to 31st december 2019. Adults who attended for the first time with an anorectal abscess and had a minimum of 1-year follow-up were included. The diagnosis was made using ICD-10 codes for anorectal abscess and anal fistula. During the study period, we included 27,821 patients with anorectal abscess. There was a predominance of men (70%) and an overall incidence of 596 per million population. The overall incidence of anal fistula developing from abscesses was 20%, with predominance in men, and a lower incidence in the lowest income level. The cumulative incidence of fistula was higher in men and in younger patients (p < 0. 0001). On multivariate analysis, patients aged 60-69 years (hazard ratio 2. 0) and those with inflammatory bowel disease (hazard ratio 1. 8-2. 0) had a strong association with fistula development (hazard ratio 2. 0). One in five patients with an anorectal abscess will develop a fistula, with a higher likelihood in men. Fistula formation was strongly associated with inflammatory bowel disease.
Note:	Altres ajuts: acords transformatius de la UAB
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Anal abscess ; Anal fistula ; Risk factors
Published in:	Techniques in Coloproctology, Vol. 27 (august 2023) , p. 897-907, ISSN 1128-045X

DOI: 10.1007/s10151-023-02840-z
PMID: 37548781

11 p, 1.5 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles