Disease Course and Colectomy Rate of Ulcerative Colitis
| Autor: | Natalia Manetti, Siro Bagnoli, Andrea Bonanomi, Francesca Rogai, Giancarlo Vannozzi, Martina Giannotta, Vito Annese |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Colectomies Adolescent Eye Diseases medicine.medical_treatment Cholangitis Sclerosing Population Kaplan-Meier Estimate Skin Diseases Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine Adrenal Cortex Hormones Risk Factors Internal medicine medicine Humans Immunologic Factors Immunology and Allergy Child education Colectomy Survival analysis Aged Retrospective Studies Aged 80 and over education.field_of_study Tumor Necrosis Factor-alpha business.industry Retrospective cohort study Middle Aged medicine.disease Ulcerative colitis Italy 030220 oncology & carcinogenesis Cohort Colitis Ulcerative Female 030211 gastroenterology & hepatology Colorectal Neoplasms business Follow-Up Studies Cohort study |
| Zdroj: | Inflammatory Bowel Diseases. 22:1945-1953 |
| ISSN: | 1078-0998 |
| Popis: | BACKGROUND The disease course and colectomy rate of ulcerative colitis (UC) vary largely in population-based and referral center cohorts. We retrospectively evaluated our cohort to determine the disease course and risk factors for colectomy. METHODS A cohort of 1723 ulcerative colitis patients (986 males; mean age, 34.8 ± 15.4 yrs) were identified and followed since 1960s for a mean of 11 ± 9 years (range, 1-49 yrs). RESULTS The disease extension was classified as E1, E2, and E3 on diagnosis at 19.7%, 54.2%, and 26.1% of patients, respectively. At the final follow-up, the disease extension increased in 20% of the cases. Extraintestinal manifestations (EIMs) were reported by 11% of the patients, whereas systemic corticosteroids (CS), IM or anti-TNFα agents were used by 68.6%, 20.4%, and 6.4% of patients, respectively. The crude colectomy rate was 7% (120 pts), with a 1.2% rate (n = 21) at 1 year from diagnosis (95% CI, 0.7-1.7) and a Kaplan-Meyer estimation of up to 18.2% after 30 years of follow-up. The 1-year colectomy rate showed no significant difference through the decades, whereas the 5-year and 10-year absolute value of colectomy was halved in the last 2 decades compared with the period from 1960 to 1990 (P = 0.01), with a general trend of a reduced colectomy rate at survival curves (P = 0.056). CONCLUSIONS The colectomy rate was low in our cohort and further reduced in the last 2 decades. However, despite the availability of anti-TNFα agents, no further significant reduction of colectomies was observed in the last decade. |
| Databáze: | OpenAIRE |
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