PURPOSE: We evaluated a large cohort of patients with longstanding ulcerative colitis in a colonoscopic surveillance program to determine predictors of colectomy. METHODS: We queried a retrospective database of patients who had symptoms of ulcerative colitis for seven years or more. Histologic inflammation in biopsies was graded on a validated four-point scale: absent, mild, moderate, severe. We performed a multivariate analysis of the inflammation scores and other variables to determine predictive factors for colectomy. Patients who underwent colectomy for neoplasia were censored at the time of surgery; those who did not undergo colectomy were censored at the time of last contact. RESULTS: A total of 561 patients were evaluated, with a median follow-up of 21.4 years since disease onset. A total of 97 patients (17.3 percent) underwent surgery; 25 (4.5 percent) for reasons other than dysplasia. These 25 constitute events for this analysis. For univariate analysis, mean inflammation (P < 0.001) and steroid use (P = 0.01) were predictors of colectomy. For multivariable proportional hazards analysis, mean inflammation (P < 0.001) and steroid use (P = 0.03) were predictors of colectomy, whereas salicylate use (P = 0.007) was protective. CONCLUSIONS: Higher median inflammation scores and corticosteroid use were predictors of colectomy in this patient population. The overall rate of colectomy during a long period of follow-up was low (<1 percent per year).
PURPOSE: We evaluated a large cohort of patients with longstanding ulcerative colitis in a colonoscopic surveillance program to determine predictors of colectomy. METHODS: We queried a retrospective database of patients who had symptoms of ulcerative colitis for seven years or more. Histologic inflammation in biopsies was graded on a validated four-point scale: absent, mild, moderate, severe. We performed a multivariate analysis of the inflammation scores and other variables to determine predictive factors for colectomy. Patients who underwent colectomy for neoplasia were censored at the time of surgery; those who did not undergo colectomy were censored at the time of last contact. RESULTS: A total of 561 patients were evaluated, with a median follow-up of 21.4 years since disease onset. A total of 97 patients (17.3 percent) underwent surgery; 25 (4.5 percent) for reasons other than dysplasia. These 25 constitute events for this analysis. For univariate analysis, mean inflammation (P < 0.001) and steroid use (P = 0.01) were predictors of colectomy. For multivariable proportional hazards analysis, mean inflammation (P < 0.001) and steroid use (P = 0.03) were predictors of colectomy, whereas salicylate use (P = 0.007) was protective. CONCLUSIONS: Higher median inflammation scores and corticosteroid use were predictors of colectomy in this patient population. The overall rate of colectomy during a long period of follow-up was low (<1 percent per year).
Authors: M Roussomoustakaki; J Satsangi; K Welsh; E Louis; G Fanning; S Targan; C Landers; D P Jewell Journal: Gastroenterology Date: 1997-06 Impact factor: 22.682
Authors: Mahmoud H Mosli; Claire E Parker; Sigrid A Nelson; Kenneth A Baker; John K MacDonald; G Y Zou; Brian G Feagan; Reena Khanna; Barrett G Levesque; Vipul Jairath Journal: Cochrane Database Syst Rev Date: 2017-05-25
Authors: Britt Christensen; Stephen B Hanauer; Jonathan Erlich; Olufemi Kassim; Peter R Gibson; Jerrold R Turner; John Hart; David T Rubin Journal: Clin Gastroenterol Hepatol Date: 2017-02-24 Impact factor: 11.382
Authors: Talia Zenlea; Eric U Yee; Laura Rosenberg; Marie Boyle; Kavinderjit S Nanda; Jacqueline L Wolf; Kenneth R Falchuk; Adam S Cheifetz; Jeffrey D Goldsmith; Alan C Moss Journal: Am J Gastroenterol Date: 2016-03-15 Impact factor: 10.864