Older adults with acute severe ulcerative colitis have similar steroid non-response and colectomy rates as younger adults

作     者：Deloshaan Subhaharan Pradeep Kakkadasam Ramaswamy Laura Willmann Hadi Moattar Maneesha Bhullar Naveed Ishaq Alexander Dorrington Dheeraj Shukla Carolyn McIvor John Edwards Waled Mohsen 

作者机构：Department of Digestive DiseasesGold Coast University HospitalGold Coast 4215QueenslandAustralia Department of GastroenterologyLogan HospitalLogan 4131QueenslandAustralia 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2023年第29卷第16期

页      面：2469-2478页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Elderly Ulcerative colitis Acute severe ulcerative colitis Colectomy Rescue therapy Infliximab 

摘      要：BACKGROUND There is paucity of data on outcomes of acute severe ulcerative colitis(ASUC)in older adults(≥60 years of age).AIM To assess steroid non-response rates during the index admission for ASUC in older *** outcomes were response to medical rescue therapy and colectomy rates;at index admission,3 and 12 *** This retrospective multicentre cohort study included ASUC admissions who received intravenous steroids between January 2013 and July 2020 at two tertiary *** medical records were reviewed to collect clinical,biochemical,and endoscopic data.A modified Poisson regression model was used for *** Of 226 ASUC episodes,45(19.9%)occurred in patients≥60 years of *** non-response rates were comparable in older adults and patients60 years of age[19(42.2%)vs 85(47%),P=0.618],crude risk ratio(RR)=0.89[95%confidence interval(CI):0.61-1.30],adjusted RR=0.99(0.44-2.21).Rates of response to medical rescue therapy in older adults was comparable to the younger cohort[76.5%vs 85.7%,P=0.46,crude RR=0.89(0.67-1.17)].Index admission colectomy[13.3%vs 10.5%,P=0.598,crude RR=1.27(0.53-2.99),adjusted RR=1.43(0.34-6.06)],colectomy at 3 mo[20%vs 16.6%,P=0.66,crude RR=1.18(0.61-2.3),adjusted RR=1.31(0.32-0.53)]and colectomy at 12 mo[20%vs 23.2%,P=0.682,crude RR=0.85(0.45-1.57),adjusted RR=1.21(0.29-4.97)],were similar between the two *** In older adults with ASUC,the steroid non-response rate,response to medical rescue therapy,and colectomy rate at index admission,3 and 12 mo is similar to patients less than 60 years of age.