| Nationwide linkage analysis in Scotland implicates age as the critical overall determinant of mortality in ulcerative colitis. | |
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MedLine Citation:
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PMID: 20236256 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recent data associated higher mortality with medical rather than surgical intervention in patients with ulcerative colitis who require hospitalization. AIM: To examine factors influencing UC-related mortality in Scotland. METHOD: Using the national record linkage database 1998-2000, 3-year mortality was determined after four admission types: colectomy-elective or emergency; no colectomy-elective or emergency. RESULTS: Of 1078 patients, crude 3-year mortality rates were: colectomy elective 5.6% (n = 177) and emergency 9.0% (100); no colectomy elective 9.8% (244) and emergency 16.0% (557). Using elective colectomy as reference, multivariate analysis [OR (95% CI)] showed that admission age >50 years [OR 5.46 (2.29-11.95)], male gender [OR 1.92 (1.23-3.02)], comorbidity [OR 2.2 (1.38-3.51)], length of stay >15 days [OR 2.04 (1.08-3.84)] and prior IBD admission [OR 1.66 (1.06-2.61)] were independently related to mortality. Age was the strongest determinant. No patient <30 years died. Mortality of patients aged <50 years [10/587 (1.7%)] was significantly lower than mortality of those aged 50-64 years [26/246 (10.6%)] (chi(2) = 32.91; P < 0.0000001) and >65 [96/245 (39.2%)] (chi(2) = 218.2; P < 0.0000001). For those patients aged more than 65 years, mortality in the four groups was 29.4%, 33.3%, 28.1% and 44.7%- all greater than expected in the Scottish population on assessment of standardized mortality ratios. CONCLUSION: Hospital admission in UC patients >65 is associated with high mortality. Management strategies should consider this by treatment in specialist units, early investigation, focused medical treatment and earlier surgical referral. |
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Authors:
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R J Nicholls; D N Clark; L Kelso; A M Crowe; A D Knight; P Hodgkins; J Satsangi |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-03-17 |
Journal Detail:
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Title: Alimentary pharmacology & therapeutics Volume: 31 ISSN: 1365-2036 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-07-08 Completed Date: 2011-01-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: England |
Other Details:
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Languages: eng Pagination: 1310-21 Citation Subset: IM |
Affiliation:
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Imperial College, St Mary's Campus, London, UK. j.nicholls@imperial.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors* Colectomy / mortality* Colitis, Ulcerative / mortality*, surgery Comorbidity Female Hospitalization / statistics & numerical data Humans Male Middle Aged Multivariate Analysis Risk Factors Scotland / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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