Abstract
Background and aim
Acute severe ulcerative colitis (ASUC) is a life-threatening condition that requires
timely referral for therapy. Sarcopenia has been associated with clinical outcomes
of inflammatory bowel disease (IBD). This study investigated the role of sarcopenia
in predicting the clinical course of ASUC.
Methods
This retrospective cohort study included ASUC patients with abdominal CT scans. Univariate
and multivariable regression analyses were performed to identify a practical predictive
index for the clinical course of ASUC.
Results
Of 233 included patients, 151 had intravenous corticosteroid (IVS) failure, among
whom 32 received surgery without medical rescue therapy. Fifty patients underwent
colectomy after medical rescue therapy failure. Of these 82 surgical patients, 42
suffered postoperative complications. Multivariable regression analysis showed that
sarcopenia remained an independent risk factor for IVS failure (OR=2.969; 95% CI,
1.547–5.701; p = 0.001), colectomy after medical rescue therapy failure (OR=3.411; 95% CI, 1.147–10.141;
p = 0.027), and postoperative complications after colectomy (OR=4.157; 95% CI, 1.364–12.667;
p = 0.012). During follow-up, patients with colectomy after first-line treatment had
a lower comprehensive complication index and better health-related quality of life.
Conclusion
Sarcopenia is useful in predicting the clinical course and postoperative outcomes
of ASUC.
Keywords
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Article info
Publication history
Published online: April 29, 2021
Accepted:
March 24,
2021
Received in revised form:
March 5,
2021
Received:
January 13,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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- Sarcopenia and acute severe ulcerative colitis patientsDigestive and Liver DiseaseVol. 53Issue 11
- PreviewGe et al. recently investigated the association between sarcopenia and clinical prognosis of patients with acute severe ulcerative colitis (ASUC) [1]. In this retrospective cohort study, after adjusting for confounding factors by multivariate regression analysis, the authors revealed that sarcopenia was associated with the poor prognosis of ASUC patients, suggesting that sarcopenia could be used in clinical practice to predict the prognosis and risk stratification of ASUC patients. Definitely, the author's great efforts provide an important basis for the treatment strategy of ASUC patients.
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