SVE biblioteke (uzajamna bibliografsko-kataloška baza podataka COBIB.SR)
13.
Long-term outcome after admission for acute severe ulcerative colitis in Oxford : the 1992-1993 cohort
Bojić, Daniela, 1965- = Бојић, Даниела, 1965- ...
Background: To determine the long-term outcome of patients admitted with acutesevere 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 timeslonger than IRs. It is unknown whether biologics change the long-term outcome.
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