{"id":1998,"date":"2014-10-01T01:00:00","date_gmt":"2014-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/mici_hebdo-enquete-sur-les-maladies-inflammatoires-de-lintestin-dans-les-centreshospitaliers-generaux-de-langh-du-2-au-15-septembre-2013\/"},"modified":"2018-10-20T18:40:12","modified_gmt":"2018-10-20T16:40:12","slug":"mici_hebdo-enquete-sur-les-maladies-inflammatoires-de-lintestin-dans-les-centreshospitaliers-generaux-de-langh-du-2-au-15-septembre-2013","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/mici_hebdo-enquete-sur-les-maladies-inflammatoires-de-lintestin-dans-les-centreshospitaliers-generaux-de-langh-du-2-au-15-septembre-2013\/","title":{"rendered":"MICI_HEBDO: enqu\u00eate sur les maladies inflammatoires de l\u2019intestin dans les centres\nhospitaliers g\u00e9n\u00e9raux de l’ANGH du 2 au 15 septembre 2013"},"content":{"rendered":"

2014<\/strong><\/p>\n

S. Nahon (1), P. Lahmek (2), T. Paupard (3), B. de Vroey (4), G. Macaigne (5), M. Boualit (6),
\nL. Costes (7), K. Elriz (8), A. Techy (9), J.-M. Maisin (4), B. Bour (10), B. Nalet (11),
\nJ. Bonnet (12), B. Mesnard (13), A. Courillon-Mallet (14), O. Nouel (15), B. Coulibaly (16),
\nI. Dadamessi (17), B. Lesgourgues (1)
\n(1) Montfermeil; (2) Limeil-Br\u00e9vannes; (3) Dunkerque; (4) Haine-Saint-Paul, BELGIQUE; (5)
\nLagny-sur-Marne; (6) Valenciennes; (7) Cr\u00e9teil; (8) Corbeil-Essonnes; (9) Roubaix; (10) Le
\nMans; (11) Mont\u00e9limar; (12) Bry-sur-Marne; (13) Tourcoing; (14) Villeneuve-Saint-Georges;
\n(15) Saint-Brieuc; (16) Avignon; (17) Saint-Quentin.<\/em><\/p>\n

Gastroent\u00e9rologie <\/strong>– \u00a02014-04-20 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Introduction
\nD\u00e9crire les caract\u00e9ristiques des patients atteints de maladie inflammatoire de l’intestin
\n(MICI) et l’\u00e9volution des pratiques dans les centres hospitaliers g\u00e9n\u00e9raux.
\nPatients et M\u00e9thodes
\nLes m\u00e9decins membres de l’ANGH ont \u00e9t\u00e9 invit\u00e9s \u00e0 r\u00e9pondre \u00e0 une enqu\u00eate en ligne
\nconcernant leurs patients atteints de MICI du 2 au 15 septembre 2013. Les caract\u00e9ristiques
\nd\u00e9mographiques et de la MICI (classification de Montr\u00e9al), les complications et les
\ntraitements (m\u00e9dicaux et chirurgicaux) ont \u00e9t\u00e9 saisis \u00e0 l’aide du logiciel LimeSurvey\u00a9. Le
\nrecours aux immunosuppresseur et anti-TNF au cours des 5 premi\u00e8res ann\u00e9es suivant le
\ndiagnostic de la maladie de Crohn (MC) ont \u00e9t\u00e9 compar\u00e9s selon la m\u00e9thode de Kaplan Meier
\ndans 4 groupes d\u00e9termin\u00e9s par la date du diagnostic de la MC (avant 1999, 2000-2003, 2004-
\n2008, 2009-2013).
\nR\u00e9sultats
\n1083 malades ont \u00e9t\u00e9 inclus par 57 centres (m\u00e9diane 17 par centre ; IQR 25-75% : 6-28). Il
\ns’agissait de 739 (68,2%) MC et 344 (31,8%) rectocolite h\u00e9morragique (RCH) ; le diagnostic
\n\u00e9tait < 6 mois dans 8,7% des cas. Le mode de recrutement \u00e9tait : une consultation 49,6%,
\nune hospitalisation de jour 34,1%, une endoscopie 11,5%, et une hospitalisation
\ntraditionnelle dans 6,7% des cas (dont 27,4% en urgence). Le sexe ratio (F\/H) \u00e9tait de 1,38
\nau cours de la MC et de 0,87 au cours de la RCH. L'\u00e2ge m\u00e9dian au diagnostic \u00e9tait de
\n27,5 ans (IQR : 20,5-39,8) et \u00e9tait significativement plus \u00e9lev\u00e9 chez les patients ayant une
\nRCH comparativement \u00e0 ceux ayant une MC (33,1 vs 25,4 ans, p<0,0001). La consommation
\nde tabac \u00e9tait de 23% et \u00e9tait significativement plus \u00e9lev\u00e9e au cours de la MC 30% vs 7 %
\nau cours de la RCH (p<0,0001). La localisation de la MC \u00e9tait : il\u00e9ale (L1) 31% ; colique (L2)
\n21,2% ; il\u00e9o-colique (L3) 44,5% et tube digestif sup\u00e9rieur (L4) dans 5,4% cas. Le ph\u00e9notype
\n\u00e9tait de type inflammatoire (B1) 59,7% ; st\u00e9nosant (B2) 26,9% et p\u00e9n\u00e9trant (B3) 12,7% des
\ncas ; 26,1% avait une localisation anop\u00e9-rin\u00e9ale. La topographie de la RCH \u00e9tait E3 (au del\u00e0
\nangle gauche) dans 43% des cas, E2 (en amont angle gauche) dans 38,9% des cas et E1
\n(rectite) dans 17,8% des cas. La maladie \u00e9tait en r\u00e9mission dans 71,7% des cas, r\u00e9mission
\nsignificati-vement associ\u00e9e \u00e0 une meilleure qualit\u00e9 de vie (p<0,0001). Une complication
\nr\u00e9volue \u00e9tait observ\u00e9e chez 37,8% des patients ayant une MC (occlusion n = 123, abc\u00e8s ou
\nfistule digestive n = 71, p\u00e9ritonite n = 13, colite grave n = 10 et aucun cancer du c\u00f4lon ou
\ndu gr\u00eale). On notait 19 colites graves et 3 cancers du c\u00f4lon parmi les 344 patients ayant une
\nRCH. Le taux de chirurgie globale \u00e9tait de 26,3% (36,5% MC vs 4% RCH) celui de chirurgie
\npr\u00e9coce (< 3 mois) \u00e9tait de 9,8% pour les patients diagnostiqu\u00e9s avant 1999 ; 8% entre
\n1999-2003 ; 5,5% entre 2004-2008 et 7,7% apr\u00e8s 2009. Les traitements en cours \u00e9taient
\npour la MC : 5ASA 23,1%, corticoides 9,8%, thiopurines 32%, methotexate 4,6%, infliximab
\n42,1%, adalimumab 11,2% ; pour la RCH : 5-ASA 62,2%, corticoides 14%, thiopurines 27%,
\nMTX 1,2%, infliximab 29,7% et adalimumab 6,7%. Au cours des cinq premi\u00e8res ann\u00e9es
\nsuivant le diagnostic de la MC, la proportion de patients sous IMS et anti-TNF augmentait
\nsignificativement respectivement (<1999 18%, 2000-2003 52%, 2004-2008 66%, 2009-2013
\n75%, p < 0,0001) et (<1999 0%, 2000-2003 23%, 2004-2008 70%, 2009-2013 100%, p <
\n0,0001).
\nConclusion
\nPendant ces 2 semaines d'enqu\u00eate, la prise en charge des MICI dans les CHG se fait
\nprincipalement en consultation et en h\u00f4pital de jour. La majorit\u00e9 des patients a une maladie
\nmod\u00e9r\u00e9e \u00e0 s\u00e9v\u00e8re et re\u00e7oit un traitement par anti-TNF α dans la moiti\u00e9 des cas. Le d\u00e9lai
\nd'initiation d'un traitement par IMS et anti-TNF α a diminu\u00e9 significativement avec le temps.<\/p>\n","protected":false},"excerpt":{"rendered":"

2014 S. Nahon (1), P. Lahmek (2), T. Paupard (3), B. de Vroey (4), G. Macaigne (5), M. Boualit (6), L. Costes (7), K. Elriz (8), A. Techy (9), J.-M. Maisin (4), B. Bour (10), B. Nalet (11), J. Bonnet (12), B. Mesnard (13), A. Courillon-Mallet (14), O. Nouel (15), B. Coulibaly (16), I. Dadamessi […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[25],"class_list":["post-1998","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-25"],"yoast_head":"\nMICI_HEBDO: enqu\u00eate sur les maladies inflammatoires de l\u2019intestin dans les centres hospitaliers g\u00e9n\u00e9raux de l'ANGH du 2 au 15 septembre 2013 - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/mici_hebdo-enquete-sur-les-maladies-inflammatoires-de-lintestin-dans-les-centreshospitaliers-generaux-de-langh-du-2-au-15-septembre-2013\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"MICI_HEBDO: enqu\u00eate sur les maladies inflammatoires de l\u2019intestin dans les centres hospitaliers g\u00e9n\u00e9raux de l'ANGH du 2 au 15 septembre 2013 - 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