Benefits of Paediatric to Adult Transition Programme in Inflammatory Bowel Disease: The BUTTERFLY Study of GETECCU and SEGHNP

被引：3

作者：

Rubin de Celix, Cristina ^{[1
]}

Martin-de-Carpi, Javier ^{[2
]}

Pujol-Muncunill, Gemma ^{[2
]}

Palomino, Laura Maria ^{[3
]}

Velasco Rodriguez-Belvis, Marta ^{[3
]}

Martin-Masot, Rafael ^{[4
]}

Navas-Lopez, Victor Manuel ^{[4
]}

Ricart, Elena ^{[5
]}

Casanova, Maria Jose ^{[1
]}

Rodriguez-Martinez, Alejandro ^{[6
]}

Leo-Carnerero, Eduardo ^{[7
]}

Alcaraz, Alba ^{[8
]}

Manosa, Miriam ^{[9
]}

Hernandez, Vicent ^{[10
]}

Cobelas Cobelas, Maria Consuelo ^{[11
]}

Sanchez, Cesar ^{[12
]}

Menchen, Luis ^{[13
]}

Mesonero, Francisco ^{[14
]}

Barreiro-De Acosta, Manuel ^{[15
]}

Martinon-Torres, Nazareth ^{[16
]}

Tejido Sandoval, Coral ^{[17
]}

Rendo Vazquez, Alicia ^{[18
]}

Corsino, Pilar ^{[19
]}

Vicente, Raquel ^{[19
]}

Hernandez-Camba, Alejandro ^{[20
]}

Alberto Alonso, Jose Ramon ^{[21
]}

Alonso-Abreu, I. ^{[22
]}

Castro Millan, Ana Maria ^{[23
]}

Peries Reverter, Laia ^{[24
]}

Castro, Beatriz ^{[25
]}

Fernandez-Salgado, Estela ^{[26
]}

Busto Cuinas, M. Mercedes ^{[27
]}

Benitez, Jose Manuel ^{[28
]}

Madero, Lucia ^{[29
]}

Clemente, Fernando ^{[30
]}

Riestra, Sabino ^{[31
]}

Jimenez-Trevino, Santiago ^{[32
]}

Bosca-Watts, Maia ^{[33
]}

Crehua-Gaudiza, Elena ^{[34
]}

Calvo Moya, Marta ^{[35
]}

Huguet, Jose Maria ^{[36
]}

Largo-Blanco, Ester-Maria ^{[37
]}

Gonzalez Vives, Leticia ^{[38
]}

Plaza, Rocio ^{[39
]}

Guerra, Ivan ^{[40
]}

Barrio, Josefa ^{[41
]}

Escartin, Laura ^{[42
]}

Alfambra, Erika ^{[43
]}

Cruz, Noelia ^{[44
]}

Munoz, M. Carmen ^{[45
]}

机构：

[1] Univ Autonoma Madrid UAM, Inst Invest Sanit Princesa IIS Princesa, Hosp Univ La Princesa, Ctro Invest Biomed Red Enfermedades Hepat D, Madrid 28006, Spain

[2] Hosp St Joan Deu, Dept Paediat Gastroenterol Hepatol & Nutr, Barcelona 08950, Spain

[3] Hosp Infantil Univ Nino Jesus, Paediat Gastroenterol & Nutr Dept, Madrid 28009, Spain

[4] Hosp Reg Univ Malaga, Biomed Res Inst Malaga IBIMA, Paediat Gastroenterol & Nutr Unit, Malaga 29010, Spain

[5] Inst Invest Biomed Agusti Pi & Sunyer IDIBAPS, Hosp Clin, Gastroenterol Dept, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona 08036, Spain

[6] Hosp Univ Virgen Rocio, Paediat Gastroenterol Hepatol & Nutr, UGC Pediat, Seville 41013, Spain

[7] Hosp Virgen Rocio, Gastroenterol Dept, Seville 41013, Spain

[8] Univ Hosp Germans Trias & Pujol, Dept Paediat Gastroenterol Nutr & Hepatol, Badalona 08916, Spain

[9] Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Badalona 08916, Spain

[10] Xerencia Xest Integrada Vigo, Galicia Hlth Res Inst IIS Galicia, Dept Gastroenterol,SERGAS, Res Grp Digest Dis,SERGAS UVIGO, Vigo 36312, Spain

[11] SERGAS, Xerencia Xest Integrada Vigo, Dept Paediat, Vigo 36312, Spain

[12] Hosp Gen Univ Gregorio Maranon, Paediat Gastroenterol Hepatol & Nutr Dept, Madrid 28018, Spain

[13] Univ Complutense Madrid, Hosp Gen Univ Gregorio Maranon, Gastroenterol Dept CEIMI, Dept Med, Madrid 28018, Spain

[14] Hosp Univ Ramon & Cajal, Gastroenterol Dept, Madrid 28034, Spain

[15] Hosp Univ Clin Santiago, Gastroenterol Dept, Santiago De Compostela 15706, Spain

[16] Hosp Univ Clin Santiago, Paediat Gastroenterol Hepatol & Nutr Unit, Santiago De Compostela 15706, Spain

[17] Complejo Hosp Univ Ourense, Gastroenterol Dept, Orense 32005, Spain

[18] Complejo Hosp Univ Ourense, Paediat Gastroenterol Hepatol & Nutr Unit, Orense 32005, Spain

[19] Hosp Univ Miguel Servet, Hlth Res Inst Aragon, Gastroenterol Dept, Inflammatory Bowel Dis Unit, Zaragoza 50009, Spain

[20] Hosp Univ Nuestra Senora Candelaria, Gastroenterol Dept, Santa Cruz De Tenerife 38010, Spain

[21] Hosp Univ Nuestra Senora Candelaria, Paediat Gastroenterol Hepatol & Nutr Unit, Santa Cruz De Tenerife 38010, Spain

[22] Hosp Univ Canarias, Gastroenterol Dept, Santa Cruz De Tenerife 38320, Spain

[23] Hosp Univ Canarias, Paediat Gastroenterol Hepatol & Nutr Unit, Santa Cruz De Tenerife 38320, Spain

[24] Hosp Univ Girona Doctor Josep Trueta, Gastroenterol Dept, Girona 17007, Spain

[25] Hosp Univ Marques Valdecilla, Gastroenterol Dept, Santander 39008, Spain

[26] Complejo Hosp Univ Pontevedra, Gastroenterol Dept, Pontevedra 36071, Spain

[27] Complejo Hosp Univ Pontevedra, Paediat Gastroenterol Hepatol & Nutr Unit, Pontevedra 36071, Spain

[28] Hosp Univ Reina Sofia, Gastroenterol Dept, IMIBIC, Cordoba 14004, Spain

[29] Hosp Univ Alicante, Inst Invest Sanit & Biomed ISABIAL, Gastroenterol Dept, Alicante 03010, Spain

[30] Hosp Univ Alicante, Hepatol & Nutr Unit, Paediat Gastroenterol, Alicante 03010, Spain

[31] Inst Invest Sanit Principado Asturias ISP, Hosp Univ Cent Asturias, Gastroenterol Dept, Oviedo 33011, Spain

[32] Hosp Univ Cent Asturias, Paediat Gastroenterol & Nutr Unit, Oviedo 33011, Spain

[33] Hosp Clin Valencia, Gastroenterol Dept, Valencia 46010, Spain

[34] Hosp Clin Valencia, Paediat Gastroenterol Hepatol & Nutr Unit, Valencia 46010, Spain

[35] Hosp Puerta Hierro, Dept Gastroenterol & Hepatol, Inflammatory Bowel Dis Unit, Madrid 28222, Spain

[36] Consorcio Hosp Gen Univ Valencia, Gastroenterol Dept, Valencia 46014, Spain

[37] Consorcio Hosp Gen Univ Valencia, Paediat Gastroenterol Hepatol & Nutr Unit, Valencia 46014, Spain

[38] Hosp Univ Infanta Leonor, Gastroenterol Hepatol & Nutr Unit, Madrid 28031, Spain

[39] Hosp Univ Infanta Leonor, Gastroenterol Dept, Madrid 28031, Spain

[40] Hosp Univ Fuenlabrada, Gastroenterol Dept, Madrid 28942, Spain

[41] Hosp Univ Fuenlabrada, Paediat Gastroenterol Unit, Madrid 28942, Spain

[42] Hosp Clin Univ Lozano Blesa, Paediat Gastroenterol Hepatol & Nutr Unit, Zaragoza 50009, Spain

[43] Hosp Clin Univ Lozano Blesa, Gastroenterol Dept, Zaragoza 50009, Spain

[44] Hosp Doctor Jose Molina Orosa, Gastroenterol Dept, Las Palmas Gran Canaria 35500, Spain

[45] Hosp Univ Basurto, Gastroenterol Dept, Bilbao 48013, Spain

[46] Hosp Torrejon, Paediat Gastroenterol Hepatol & Nutr Unit, Madrid 28850, Spain

[47] Hosp Torrejon, Gastroenterol Dept, Madrid 28850, Spain

[48] Hosp Univ Infanta Cristina, Gastroenterol Dept, Madrid 28981, Spain

[49] Ctr Consorci Sanit Terrassa, Gastroenterol Dept, Terrassa 08227, Spain

[50] Hosp Henares, Gastroenterol Dept, Madrid 28822, Spain

来源：

JOURNAL OF CLINICAL MEDICINE | 2023年 / 12卷 / 14期

关键词：

transition; transitional care; inflammatory bowel disease; CROHNS-DISEASE; CARE; ADOLESCENT; RECOMMENDATIONS; PATIENT; SOCIETY; INDEX; IBD;

D O I：

10.3390/jcm12144813

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

(1) Background: Transition is a planned movement of paediatric patients to adult healthcare systems, and its implementation is not yet established in all inflammatory bowel disease (IBD) units. The aim of the study was to evaluate the impact of transition on IBD outcomes. (2) Methods: Multicentre, retrospective and observational study of IBD paediatric patients transferred to an adult IBD unit between 2017-2020. Two groups were compared: transition (& GE;1 joint visit involving the gastroenterologist, the paediatrician, a programme coordinator, the parents and the patient) and no-transition. Outcomes within one year after transfer were analysed. The main variable was poor clinical outcome (IBD flare, hospitalisation, surgery or any change in the treatment because of a flare). Predictive factors of poor clinical outcome were identified with multivariable analysis. (3) Results: A total of 278 patients from 34 Spanish hospitals were included. One hundred eighty-five patients (67%) from twenty-two hospitals (65%) performed a structured transition. Eighty-nine patients had poor clinical outcome at one year after transfer: 27% in the transition and 43% in the no-transition group (p = 0.005). One year after transfer, no-transition patients were more likely to have a flare (36% vs. 22%; p = 0.018) and reported more hospitalisations (10% vs. 3%; p = 0.025). The lack of transition, as well as parameters at transfer, including IBD activity, body mass index < 18.5 and corticosteroid treatment, were associated with poor clinical outcome. One patient in the transition group (0.4%) was lost to follow-up. (4) Conclusion: Transition care programmes improve patients' outcomes after the transfer from paediatric to adult IBD units. Active IBD at transfer impairs outcomes.

引用

页数：19

共 33 条

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