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

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World Journal of Gastroenterology 2023年第16期29卷 2469-2478页

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 Department of Digestive Diseases Gold Coast University HospitalGold Coast 4215QueenslandAustralia Department of Gastroenterology Logan HospitalLogan 4131QueenslandAustralia

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 patients<60 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.

关键词： Elderly Ulcerative colitis Acute severe ulcerative colitis Colectomy Rescue therapy Infliximab

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