Publication:
¿Ha disminuido la colectomía por crisis de colitis ulcerosa?

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Abstract

Background: Treatment for moderate-severe active ulcerative colitis (UC) includes steroids, biologic therapy and total colectomy.

Aim: To describe the features of patients with moderate to severe active UC, their hospital evolution and need for colectomy.

Material and Methods: Non-concurrent cohort study of all patients admitted to our institution with a diagnosis of moderate or severe UC crisis between January 2008 and May 2019. Truelove Witts (TW) criteria were used to categorize disease severity. Twelve-month colectomy-free survival was estimated with Kaplan-Meier survival analysis.

Results: One hundred-twenty patients aged 16 to 89 (median 35) years had 160 admissions for acute moderate to severe UC. Median admission per patient was 1 (1-3), and median hospital stay was six days (1-49). Cytomegalovirus and Clostridioides difficile were found in 17.5 and 14.2% of crises, respectively. Corticosteroids were used in all crises and biologic therapy in 6.9% of them. Emergency or elective colectomies were performed in 18.3 and 6.7% of patients, respectively. The need for emergency total colectomy decreased from 24.6 to 7.8% (Risk ratio 3.16, p < 0.01) between de first and second half of the study period. Kaplan-Meier analysis for long term colectomy-free survival in both periods confirmed this decrease (p < 0.01).

Conclusions: Medical treatment for moderate to severe UC crises had a 86.3% success and a small percentage required emergency total colectomy. Emergency surgery decreased in the last decade.

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Keywords

Colectomy, Colitis, Ulcerative, Inflammatory Bowel Diseases

Citation

Besser Nicolás, Chacón Erika, Iglesias Andrés, Álvarez-Lobos Manuel, Pavez Carolina, Villalón Constanza et al . ¿Ha disminuido la colectomía por crisis de colitis ulcerosa?. Rev. méd. Chile [Internet]. 2023 Mar [citado 2024 Mayo 28] ; 151( 3 ): 313-320. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872023000300313&lng=es. http://dx.doi.org/10.4067/s0034-98872023000300313.