J Falvey1, R Greenwood2, T J Creed1,3, J Smithson1, P Sylvester4, A Fraser1, C S Probert1,3. 1. Department of Gastroenterology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK. 2. Research Design Service, UH Bristol Education Centre, Bristol, UK. 3. Clinical Sciences at South Bristol, University of Bristol, Bristol, UK. 4. Department of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Abstract
OBJECTIVES: To determine the 3 year mortality of patients admitted to hospital for the treatment of ulcerative colitis (UC). DESIGN: Retrospective case note review of all patients admitted to hospital for treatment of active UC over a 6 year period from 1 January 2000. SETTING: Teaching hospital with a tertiary referral practice for the management of infiammatory bowel disease. PATIENTS: 106 patients (134 admissions) met the inclusion criteria. INTERVENTIONS: Elective and emergency colectomy was undertaken in 16 and 26 patients, respectively. MAIN OUTCOME MEASURES: Mortality at 3 years. RESULTS: There were six deaths after 3 years. Case fatality at 30 days, 1, 2 and 3 years was 1.0% (95% CI 0.2 to 5.1), 1.9% (95% CI 0.2 to 6.6), 2.9% (95% CI 5.9 to 8.0) and 5.7% (95% CI 2.1 to 11.9), respectively. There were no deaths in either surgical group. One patient (89 years, female) died while awaiting emergency colectomy. Patients who died were significantly older at the time of admission (79 years (95% CI 71 to 88 years) vs 41.2 years (95% CI 38 to 45 years)) and were more likely to have comorbid illness (p<0.001). Severity of disease, prior immunosuppressive use, first presentation and smoking status were not associated with increased mortality. CONCLUSIONS: Three year mortality following admission for treatment of UC was 5.7% (95% CI 2.1 to 11.9), significantly lower than that reported previously. Mortality was significantly associated with increasing age and the presence of comorbid disease. Disease specific factors such as severity, extent and first presentation were associated with emergency colectomy but not mortality.
OBJECTIVES: To determine the 3 year mortality of patients admitted to hospital for the treatment of ulcerative colitis (UC). DESIGN: Retrospective case note review of all patients admitted to hospital for treatment of active UC over a 6 year period from 1 January 2000. SETTING: Teaching hospital with a tertiary referral practice for the management of infiammatory bowel disease. PATIENTS: 106 patients (134 admissions) met the inclusion criteria. INTERVENTIONS: Elective and emergency colectomy was undertaken in 16 and 26 patients, respectively. MAIN OUTCOME MEASURES: Mortality at 3 years. RESULTS: There were six deaths after 3 years. Case fatality at 30 days, 1, 2 and 3 years was 1.0% (95% CI 0.2 to 5.1), 1.9% (95% CI 0.2 to 6.6), 2.9% (95% CI 5.9 to 8.0) and 5.7% (95% CI 2.1 to 11.9), respectively. There were no deaths in either surgical group. One patient (89 years, female) died while awaiting emergency colectomy. Patients who died were significantly older at the time of admission (79 years (95% CI 71 to 88 years) vs 41.2 years (95% CI 38 to 45 years)) and were more likely to have comorbid illness (p<0.001). Severity of disease, prior immunosuppressive use, first presentation and smoking status were not associated with increased mortality. CONCLUSIONS: Three year mortality following admission for treatment of UC was 5.7% (95% CI 2.1 to 11.9), significantly lower than that reported previously. Mortality was significantly associated with increasing age and the presence of comorbid disease. Disease specific factors such as severity, extent and first presentation were associated with emergency colectomy but not mortality.
Authors: T Jess; E V Loftus; W S Harmsen; A R Zinsmeister; W J Tremaine; L J Melton; P Munkholm; W J Sandborn Journal: Gut Date: 2006-01-19 Impact factor: 23.059
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