Abstract / Description of output
P>Background
Recent data associated higher mortality with medical rather than surgical intervention in patients with ulcerative colitis who require hospitalization.
Aim
To examine factors influencing UC-related mortality in Scotland.
Method
Using the national record linkage database 1998-2000, 3-year mortality was determined after four admission types: colectomy-elective or emergency; no colectomy-elective or emergency.
Results
Of 1078 patients, crude 3-year mortality rates were: colectomy elective 5.6% (n = 177) and emergency 9.0% (100); no colectomy elective 9.8% (244) and emergency 16.0% (557). Using elective colectomy as reference, multivariate analysis [OR (95% CI)] showed that admission age > 50 years [OR 5.46 (2.29-11.95)], male gender [OR 1.92 (1.23-3.02)], comorbidity [OR 2.2 (1.38-3.51)], length of stay > 15 days [OR 2.04 (1.08-3.84)] and prior IBD admission [OR 1.66 (1.06-2.61)] were independently related to mortality. Age was the strongest determinant. No patient < 30 years died. Mortality of patients aged < 50 years [10/587 (1.7%)] was significantly lower than mortality of those aged 50-64 years [26/246 (10.6%)] (chi 2 = 32.91; P < 0.0000001) and > 65 [96/245 (39.2%)] (chi 2 = 218.2; P < 0.0000001). For those patients aged more than 65 years, mortality in the four groups was 29.4%, 33.3%, 28.1% and 44.7%- all greater than expected in the Scottish population on assessment of standardized mortality ratios.
Conclusion
Hospital admission in UC patients > 65 is associated with high mortality. Management strategies should consider this by treatment in specialist units, early investigation, focused medical treatment and earlier surgical referral.
Original language | English |
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Pages (from-to) | 1310-1321 |
Number of pages | 12 |
Journal | Alimentary Pharmacology and Therapeutics |
Volume | 31 |
Issue number | 12 |
DOIs | |
Publication status | Published - 15 Jun 2010 |