Perianal Crohn's Disease in a Large Multicenter Pediatric Collaborative.

Background: Although perianal complications of Crohn's disease (CD) are commonly encountered in clinical practice, the epidemiology of perianal CD among populations of children is poorly understood. We sought to characterize the prevalence of perianal disease in a large and diverse population of pediatric CD patients. Methods: We conducted retrospective analyses from a prospective observational cohort, the ImproveCareNow Network (May 2006-October 2014), a multicenter pediatric inflammatory bowel disease quality improvement collaborative. Clinicians prospectively documented physical examination and phenotype classification at outpatient visits. Perianal exam findings and concomitant phenotype change were used to corroborate time of new-onset perianal disease. Results were stratified by age, sex, and race and compared across groups with logistic regression. Cumulative incidence was estimated using Kaplan-Meier analyses and compared between groups with Cox proportional hazard regression models. Results: The registry included 7,076 patients with CD (41% female). Missing/conflicting entries resulted in 397 (6%) patient exclusions. Among the remaining 6,679 cases, 1,399 (21%) developed perianal disease. Perianal disease was more common among males (22%) than females (20%; p=0.013) and developed sooner after diagnosis among those with later rather than early onset disease (p

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