Esophagus to Small Intestine
Inflamm Bowel Dis. 2025;31(1):123-130
Prior appendectomy is associated with a milder clinical course in Crohn’s disease: A nationwide population-based cohort study
Background: Appendectomy may affect the clinical course of Crohn’s disease (CD), but rigorous evidence is sparse and contradicting. The aim of this study was to examine the association between appendectomy and the clinical course of CD. Methods: All patients diagnosed with CD in Denmark in the period from 1977 to 2017 were identified from the Danish National Patient Registry. Patients with appendectomy were matched with up to 10 comparators with CD and no appendectomy; and rates of CD-related hospital admissions were compared between CD patients with and without appendectomy using incidence rate ratios (IRRs). The authors used stratified Cox regression analysis to calculate adjusted hazard ratios (aHRs) of initiating treatment with biologics or undergoing intestinal resections. Results: In all, 21,189 CD patients (1936 with appendectomy and 19,253 without) were identified and followed for a median of 13.6 years. CD patients who had undergone appendectomy experienced a lower rate of CD-related hospital admissions (appendectomy before CD: IRR = 0.83; 95% confidence interval [CI]: 0.81–0.85; appendectomy after CD: IRR = 0.85; 95% CI: 0.81–0.88) compared with CD patients without appendectomy. For patients with appendectomy before CD diagnosis, the rate of initiating biologics was lower compared with CD patients with no appendectomy (aHR[–
Conclusion: The clinical course of Crohn’s disease is milder for those who have previously undergone appendectomy.
DOI: 10.1093/ibd/izae059