Abstract
Background
About 20% of ulcerative colitis patients will experience a severe attack during the
course of the disease. Intensive treatment, early surgery and, more recently, “rescue
therapies” improved prognosis.
Aims
To evaluate in-hospital colectomy and mortality rates for severe ulcerative colitis
over 40 years in two referral centres.
Methods
All in-patients with severe ulcerative colitis from 1976 to 2010 were considered.
159 patients were assigned to 4 cohorts: cohort 1 n = 34 (1976–1980); cohort 2 n = 29 (1986–1990); cohort 3 n = 45 (1996–2000); cohort 4 n = 51 (2006–2010).
Results
The colectomy rate was 64.7%, 62.0%, 44.4% and 9.8%, respectively, in the four cohorts
(p < 0.0001). The mortality rate decreased from 8.8% in cohort 1, to 0 in cohort 4 (p = 0.04). Infliximab was used only in cohort 4 (17 patients).
Conclusions
A significant reduction of colectomy and mortality rates in severe ulcerative colitis
was observed in the last 40 years. Better management of patients, reduced attitude
to operate severe ulcerative colitis, as well as the use of Infliximab in the last
cohort, all could have contributed to the improved outcome.
Keywords
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Article info
Publication history
Published online: February 04, 2016
Accepted:
December 22,
2015
Received:
September 26,
2015
Identification
Copyright
© 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.
