Risk factors for complications in patients with ulcerative colitis
| Autor: | Gerhard Rogler, Jan Borovicka, Frank Seibold, Michael Fried, Christine N. Manser, Stephan R. Vavricka, Peter L. Lakatos |
|---|---|
| Přispěvatelé: | University of Zurich, Manser, Christine N |
| Jazyk: | němčina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Malabsorption complication 610 Medicine & health Inflammatory bowel disease Gastroenterology mesalamine Primary sclerosing cholangitis 03 medical and health sciences 0302 clinical medicine extraintestinal manifestation Internal medicine medicine 2715 Gastroenterology Risk factor Erythema nodosum business.industry Odds ratio Original Articles medicine.disease Ulcerative colitis 3. Good health 10219 Clinic for Gastroenterology and Hepatology Oncology risk factor 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology 2730 Oncology business Cohort study |
| Zdroj: | United European Gastroenterology Journal |
| Popis: | Background Patients with ulcerative colitis may develop extraintestinal manifestations like erythema nodosum or primary sclerosing cholangitis or extraintestinal complications like anaemia, malabsorption or they may have to undergo surgery. Objective The aim of this study was to investigate potential risk factors for complications like anaemia, malabsorption or surgery in ulcerative colitis. Methods Data on 179 patients with ulcerative colitis were retrieved from our cross-sectional and prospective Swiss Inflammatory Bowel Disease Cohort Study data base for a median observational time of 4.2 years. Data were compared between patients with (n = 140) or without (n = 39) complications. Gender, age at diagnosis, smoking status, disease extent, delay of diagnosis or therapy, mesalamine (5-ASA) systemic and topical therapy, as well as other medication were analysed as potential impact factors. Results In the multivariate regression analysis a delay of 5-ASA treatment by at least two months (odds ratio (OR) 6.21 (95% confidence interval (CI) 2.13–18.14), p = 0.001) as well as a delay with other medication with thiopurines (OR 6.48 (95% CI 2.01–20.91), p = 0.002) were associated with a higher risk for complications. This significant impact of a delay of 5-ASA therapy was demonstrated for extraintestinal manifestations (EIMs) as well as extraintestinal complications (EICs). Extensive disease as well as therapy with methotrexate showed a significantly increased risk for surgery (extensive disease: OR 2.62 (1.02–6.73), p = 0.05, methotrexate: OR 5.36 (1.64–17.58), p = 0.006). Conclusions A delay of 5-ASA therapy of more than two months in the early stage of ulcerative colitis (UC) constitutes a risk for complications during disease course. Extensive disease is associated with a higher risk for surgery. |
| Databáze: | OpenAIRE |
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