Prevalence and risk factors for early medical and surgical complications following an admission for acute severe ulcerative colitis.

IF 3.9 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Therapeutic Advances in Gastroenterology Pub Date : 2023-12-04 eCollection Date: 2023-01-01 DOI:10.1177/17562848231215148

Angel Li, Matthew Coote, Lena Thin

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引用次数: 0

Abstract

Background: Risk factors for colectomy following an episode of acute severe ulcerative colitis (ASUC) have been well studied, but data examining the early complications following an episode is limited.

Objectives: We aimed to evaluate the prevalence and risk factors for medical and surgical complications within 90 days of an ASUC admission and determine if a high-intensity induction infliximab dose is associated with these complications.

Design: Retrospective analysis.

Methods: We conducted a retrospective study of ASUC admissions between January 2015 and July 2021 at a tertiary hospital. The primary outcome was the prevalence of total, medical and surgical complications within 90 days following an ASUC admission. Multivariate linear regression analysis assessed for factors associated with the prevalence of complications.

Results: A total of 150 patients had 186 hospital admissions for ASUC. In total, 101/186 (54.3%) admissions required rescue medical therapy. Standard infliximab induction occurred in 65/100 admissions, accelerated infliximab induction in 35/100 and cyclosporine in 1/100 of admissions. In total, 117 complications, including 74/117 (63.2%) medical and 43/117 (36.8%) surgical complications, arose. Low serum albumin was independently associated with a higher incidence of total [β = -0.08 (95% confidence interval (CI): -0.15, -0.01), p = 0.03] and surgical complications [β = -0.1 (95% CI: -0.18, -0.001), p = 0.047], while an increased age was associated with increased incidence of surgical complications [β = 0.06 (95% CI: 0.01, 0.12), p = 0.02]. A higher Charlson score was associated with increased medical complications [β = 0.12 (95% CI: 0.01, 0.24), p = 0.03]. Infliximab induction dose intensity was not associated with an increased incidence of any complications.

Conclusion: Early complications following an ASUC admission is prevalent although the majority are not serious. Risk factors associated with complications include low serum albumin, older age and a higher comorbidity score. Induction infliximab dose intensity, however, is not a risk factor.

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急性严重溃疡性结肠炎入院后早期内科和外科并发症的患病率和危险因素

背景:急性严重溃疡性结肠炎(ASUC)发作后结肠切除术的危险因素已经得到了很好的研究，但发作后早期并发症的数据有限。目的:我们旨在评估ASUC入院90天内医疗和手术并发症的患病率和危险因素，并确定高强度诱导英夫利昔单抗剂量是否与这些并发症相关。设计:回顾性分析。方法:对某三级医院2015年1月至2021年7月收治的ASUC患者进行回顾性研究。主要结局是ASUC入院后90天内总并发症、内科并发症和外科并发症的发生率。多变量线性回归分析评估与并发症发生率相关的因素。结果:150例ASUC患者共186例住院。总共有101/186(54.3%)入院患者需要急救治疗。标准英夫利昔单抗诱导率为65/100，加速英夫利昔单抗诱导率为35/100，环孢素诱导率为1/100。共发生117例并发症，其中内科并发症74/117例(63.2%)，外科并发症43/117例(36.8%)。低血清白蛋白与较高的总发生率[β = -0.08(95%可信区间(CI): -0.15， -0.01)， p = 0.03]和手术并发症[β = -0.1 (95% CI: -0.18， -0.001)， p = 0.047]独立相关，而年龄的增加与手术并发症发生率的增加相关[β = 0.06 (95% CI: 0.01, 0.12)， p = 0.02]。Charlson评分越高，并发症越多[β = 0.12 (95% CI: 0.01, 0.24)， p = 0.03]。英夫利昔单抗诱导剂量强度与任何并发症发生率的增加无关。结论:ASUC入院后早期并发症普遍存在，但大多数并不严重。与并发症相关的危险因素包括低血清白蛋白、年龄较大和较高的合并症评分。然而，诱导英夫利昔单抗剂量强度不是一个危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.70

自引率

2.40%

发文量

103

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.