Influence of age at diagnosis on the clinical characteristics of Crohn's disease in Korea: Results from the CONNECT study

J Gastroenterol Hepatol. 2017 Oct;32(10):1716-1722. doi: 10.1111/jgh.13775.


Background and aim: The present study evaluated the clinical characteristics of Korean patients with Crohn's disease (CD) according to their age at diagnosis in a nationwide multicenter cohort study.

Methods: A total of 1224 patients diagnosed with CD between 1982 and 2008 in 32 hospitals were included, and age at diagnosis was categorized as ≤ 16 (G1), 17-40 (G2), 41-59 (G3) and ≥ 60 (G4) years old. The baseline characteristics, medication, and intestinal resection were compared according to the age at diagnosis.

Results: The number of patients in each age group was 155 (G1; 12.7%), 919 (G2; 75.1%), 120 (G3; 9.8%), and 30 (G4; 2.5%). The frequencies of ileocolonic disease in the late adult onset and elderly onset groups were lower than those in the other groups (P < 0.001). The cumulative probabilities of thiopurine and anti-tumor necrosis factor use in late adult onset and elderly onset groups were significantly reduced compared with those of the other groups (P < 0.01). However, the risk of the first intestinal resection was not different among the age groups. The ileal location (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.11-2.27), complicated behavior (HR: 3.35; 95% CI: 2.63-4.27), and early thiopurine use (HR: 0.27; 95% CI: 0.17-0.43) were associated with the first intestinal resection, whereas the age at diagnosis was not a risk factor.

Conclusions: Elderly onset CD may be related to favorable outcomes in Korea. Thus, the heterogeneity of this disease should be considered when developing a tailored strategy for the treatment of CD.

Keywords: Crohn's disease; age at diagnosis; intestinal resection; medication.

MeSH terms

  • Adalimumab / therapeutic use
  • Adolescent
  • Adult
  • Age of Onset*
  • Azathioprine / therapeutic use
  • Cohort Studies
  • Crohn Disease / diagnosis*
  • Crohn Disease / drug therapy
  • Crohn Disease / epidemiology*
  • Crohn Disease / surgery
  • Digestive System Surgical Procedures
  • Female
  • Follow-Up Studies
  • Humans
  • Infliximab / therapeutic use
  • Intestines / surgery
  • Male
  • Mercaptopurine / therapeutic use
  • Middle Aged
  • Multicenter Studies as Topic
  • Prognosis
  • Republic of Korea / epidemiology
  • Time Factors
  • Young Adult


  • Infliximab
  • Mercaptopurine
  • Adalimumab
  • Azathioprine