You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Longterm outcome after admission for acute severe ulcerative colitis in Oxford: The 19921993 cohort

Bojic, D. MD1,2; Radojicic, Z. PhD3; Nedeljkovic‐Protic, M. MD2; Al‐Ali, M. MD1; Jewell, D. P. MD1; Travis, S. P.L. MD1,*

Inflammatory Bowel Diseases:
doi: 10.1002/ibd.20843
Original Article: Original Clinical Articles
Abstract

Background:: To determine the long‐term outcome of patients admitted with acute severe colitis (ASC) who avoided colectomy on the index admission, a retrospective cohort study was performed.

Methods:: Patients admitted for intensive treatment of ASC in 1992–1993 previously described for a predictive index of short‐term outcome in severe ulcerative colitis (UC) were followed for a median 122 months (range 3–144). Complete responders (CR) to intensive therapy had <3 nonbloody stools/day on day 7 of the index admission; incomplete responders (IR) were all others who avoided colectomy on that admission. Main outcome measures were colectomy‐free survival, time to colectomy, and duration of steroid‐free remission.

Results:: In all, 6/19 CR (32%) came to colectomy compared to 10/13 IR (P = 0.016; relative risk 3.33, 95% confidence interval [CI] 1.12–9.9). The median ± interquartile range time to colectomy was 28 ± 47 months (range 6–99) for CR who came to colectomy versus 7.5 ± 32 (3–72) months for IR (P = 0.118). Among the IR, 7/13 came to colectomy within 12 months, and all within 6 years from the index admission. The longest period of steroid‐free remission was 42 ± 48 (0–120) months for CR, but 9 ± 20 (1–35) months for IR (P = 0.011).

Conclusions:: One week after admission with ASC in the prebiologic era, IRs had a 50% chance of colectomy within a year and 70% within 5 years, despite cyclosporin and azathioprine where appropriate. The maximum duration of remission in CRs was almost 5 times longer than IRs. It is unknown whether biologics change the long‐term outcome.

Author Information

1 Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK

2 Gastroenterology Department, University Clinical Center Zvezdara, Belgrade, Serbia

3 Institute for Statistics, University of Belgrade, Belgrade, Serbia

*Gastroenterology Unit, John Radcliffe Hospital, Oxford, OX3 9DU, UK

Email: simon.travis@ndm.ox.ac.uk

Received 27 October 2008; Accepted 4 November 2008

Published online 14 January 2009 in Wiley Inter‐Science (www.interscience.wiley.com).

© Crohn's & Colitis Foundation of America, Inc.

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.