Risk factors and indications for colectomy in ulcerative colitis patients are different according to patient's clinical background.

Full Abstract

PURPOSE:
Despite progress in medical treatment for ulcerative colitis, a considerable fraction of ulcerative colitis patients undergo colectomy. We analyzed the clinical variables of ulcerative colitis patients and determined the risk factors and indications for colectomy.

METHODS:
The clinical records of 981 consecutive Japanese patients with ulcerative colitis were reviewed both retrospectively and prospectively.

RESULTS:
Of 981 patients with ulcerative colitis, 85 patients underwent colectomy. Multivariate analysis indicated that male gender (risk ratio, 2.16; 95 percent confidence interval, 1.37-3.42), onset year during and after 2000 (risk ratio, 2.85; 95 percent confidence interval, 1.31-6.22), severe disease activity (risk ratio, 2; 95 percent confidence interval, 1.15-3.48), corticosteroid resistance (risk ratio, 7.05; 95 percent confidence interval, 4.29-11.59), and complications because of corticosteroid administration (risk ratio, 3.55; 95 percent confidence interval, 2.08-6.06) were significant risk factors for colectomy. In patients with disease duration of more than five years, only corticosteroid resistance and complications because of corticosteroid were significant risk factors for colectomy. When we stratified indications for colectomy for the 85 cases via patient disease duration, massive hemorrhage was a relatively frequent cause of colectomy in patients with a disease duration of less than five years (P = 0.091). On the other hand, colon dysplasia or cancer was a major cause for colectomy in patients with a disease duration of more than ten years (P = 0.0001).

CONCLUSIONS:
In ulcerative colitis patients, the risk factors and indications for colectomy were different according to the patient's clinical background. Our findings may help to predict patients with ulcerative colitis who have a high risk for colectomy.

Learn Faster Today Improve your study skills

Author information

Author/s: Kuriyama, Motoaki (M); Kato, Jun (J); Fujimoto, Tsuyoshi (T); Nasu, Junichirou (J); Miyaike, Jiro (J); Morita, Takechiyo (T); Okada, Hiroyuki (H); Suzuki, Seiyuu (S); Shiode, Junji (J); Yamamoto, Hiroshi (H); Shiratori, Yasushi (Y);

Affiliation: Department of Gastroenterology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.

Journal and publication information

Publication Type: Journal Article

Journal: Diseases of the colon and rectum (Dis Colon Rectum), published in United States. (Language: eng)

Reference: 2006-Sep; vol 49 (issue 9) : pp 1307-15

Dates: Created 2006/09/14; Completed 2006/11/09;

PMID: 16741598, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adrenal Cortex Hormones - therapeutic use
Adult
Age of Onset
Colectomy - adverse effects
Colitis, Ulcerative - drug therapy; surgery

Colitis, Ulcerative - drug therapy; surgery
Female
Humans
Male
Risk Factors

Associated Chemicals: Adrenal Cortex Hormones (0)

These are the highest related articles currently in the database:

See 100+ related articles.