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A Review of Mortality and Surgery in Ulcerative Colitis: Milestones of the Seriousness of the Disease

Bernstein, Charles N. MD*; Ng, Siew C. MD; Lakatos, Peter L. MD; Moum, Bjorn MD§; Loftus, Edward V. Jr MDon the behalf of the Epidemiology and Natural History Task Force of the International Organization of the Study of Inflammatory Bowel Disease

doi: 10.1097/MIB.0b013e318281f3bb
Clinical Review Article

Abstract: Standardized mortality rates in ulcerative colitis (UC) are no different than that in the general population. Patients who are older and have more comorbidities have increased mortality. Emergent colectomy still carries 30-day mortality rates of approximately 5%. In more recent studies, UC surgery rates at 10 years from diagnosis are nearly 3% in Hungary, <10% in referral center studies from Asia, approximately 10% in Norway, the European Cohort Study of Inflammatory Bowel Diseases and Manitoba, Canada, and nearly 17% in Olmsted County, Minnesota. These rates are for the most part lower than reported colectomy rates from studies completed before 1990. Short-term colectomy rates in severe hospitalized UC have remained stable at 27% for several years. Generally, children seem to have higher rates of extensive colitis at diagnosis than adults. There also seems to be higher rates of colectomy in children than in adults (i.e., at least 20% at 10 years), and perhaps, this reflects a higher rate of extensive disease. Acute severe colitis in patients with UC still represents a condition with a high early colectomy rate and a measurable mortality rate.

Article first published online 24 April 2013

*Section of Gastroenterology, IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada;

Department of Internal Medicine, Institute of Digestive Diseases, Chinese University of Hong Kong, Hong Kong;

1st Department of Medicine, Semmelweis University, Budapest, Hungary;

§Department of Gastroenterology, Oslo University Hospital and University of Oslo, Oslo, Norway; and

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

Reprints: Charles N. Bernstein, MD, 804F-715 McDermot Avenue, Winnipeg, Manitoba, Canada R3E3P4 (e-mail:

C.N.B. consults to Abbvie Canada and Abboott Canada, Janssen Canada, Shire Canada, and has received an unrestricted educational grant from each of Abbott and of Abbvie Canada.

The authors have no other conflicts of interest to disclose.

Received October 10, 2012

Accepted November 15, 2012

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