Patients who require hospitalization for the management of ulcerative colitis may represent a subset with severe disease.
These patients may be more likely to require future colectomy.
There are limited data examining whether medical hospitalization is predictive of subsequent colectomy.
Dr Ashwin Ananthakrishnan and colleagues from Pennsylvania, USA retrospectively studied the inflammatory bowel disease (IBD) database at their academic referral center.
Cases comprised ulcerative colitis patients who underwent colectomy for disease refractory to medical management.
The control population was comprised of all patients with ulcerative colitis who had not undergone colectomy.
Multivariate logistic regression was used to identify independent predictors of requiring colectomy.
The researchers evaluated a total of 246 ulcerative colitis patients, with 42% being hospitalized sometime in their disease course.
|Ever requiring infliximab therapy was an independent predictor of colectomy|
|Inflammatory Bowel Diseases|
A total of 11% patients underwent colectomy.
Colectomy patients were significantly more likely to have been on infliximab therapy, but no more likely to have been on immunomodulator therapy.
Patients who required medical hospitalization for ulcerative colitis were more likely to require future colectomy than those who had not required hospitalization.
On multivariate analysis, requiring medical hospitalization for management of ulcerative colitis, and ever requiring infliximab therapy were independent predictors of colectomy.
Dr Ananthakrishnan’s team concluded, “Requiring medical hospitalization for the management of disease activity in ulcerative colitis is an independent predictor of the need for colectomy.”
“Future studies will determine whether aggressive medical management may modify the need for colectomy in this cohort.”