Short-term and long-term outcomes of acute severe ulcerative colitis in Taiwan: a multicenter study with pre- and post-biologics comparison.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2025-01-24 DOI:10.5217/ir.2024.00112

Wei-Chen Lin, Chun-Chi Lin, Wen-Hung Hsu, Feng-Fan Chiang, Chen-Wang Chang, Tzu-Chi Hsu, Deng-Chyang Wu, Horng-Yuan Wang, Jau-Min Wong, Shu-Chen Wei

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引用次数: 0

Abstract

Background/aims: Data from Asia regarding the short-term and long-term outcomes for acute severe ulcerative colitis (ASUC) are limited. We assessed the outcomes of ASUC, identified the risk factors for colectomy, and compared colectomy rates between the pre-biologics and post-biologics eras in Taiwan.

Methods: The patients with an ASUC diagnosis between January 2013 and March 2022 at 5 tertiary medical centers were retrospectively analyzed.

Results: In total, 98 patients were enrolled, with 68.4% diagnosed in the post-biologics era. In 78.6% of the ASUC patients initially received intravenous steroid therapy, for which the success rate was 74.1%. As for rescue therapy, 15 patients (93.8%) received biologics and 1 (6.3%) received cyclosporin. Biologics rescue therapy had a 93.3% success rate. One (1%) mortality due to septic shock occurred. The colectomy rate for index ASUC admission was 11.2%. Patients receiving colectomy were predominantly male (P= 0.012) and at older age (P= 0.016). Higher C-reactive protein (P= 0.035), lower albumin (P= 0.017), and hemoglobin (P= 0.023) levels were associated with colectomy risk. During a median follow-up of 24 months, 13 patients (15.1%) had recurrent ASUC and 23.1% of patients received colectomy. The accumulated colectomy rate at 3 years did not differ between the pre- and post-biologics eras (16.1% vs. 13.4%, P= 0.270).

Conclusions: This is the first Asian study on ASUC to compare colectomy rates between the prebiologics and post-biologics eras, revealing no significant difference. The recurrent ASUC had a higher colectomy rate than the index ASUC.

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台湾地区急性重度溃疡性结肠炎的短期及长期预后：一项多中心研究及生物制剂前后比较。

背景/目的：来自亚洲的关于急性严重溃疡性结肠炎（ASUC）短期和长期结局的数据有限。我们评估了ASUC的预后，确定了结肠切除术的危险因素，并比较了台湾地区使用生物制剂前和使用生物制剂后的结肠切除术率。方法：回顾性分析2013年1月至2022年3月在5家三级医疗中心诊断为ASUC的患者。结果：共纳入98例患者，其中68.4%诊断为后生物制剂时代。78.6%的ASUC患者最初接受静脉类固醇治疗，成功率为74.1%。在抢救治疗方面，使用生物制剂15例（93.8%），环孢素1例（6.3%）。生物制剂抢救治疗成功率为93.3%。1例（1%）因感染性休克死亡。指数ASUC入院结肠切除术率为11.2%。接受结肠切除术的患者以男性（P= 0.012）和年龄较大（P= 0.016）为主。较高的c反应蛋白（P= 0.035）、较低的白蛋白（P= 0.017）和血红蛋白（P= 0.023）水平与结肠切除术风险相关。在中位随访24个月期间，13名患者（15.1%）复发ASUC， 23.1%的患者接受了结肠切除术。3年累积结肠切除术率在使用生物制剂前和使用生物制剂后没有差异（16.1% vs 13.4%， P= 0.270）。结论：这是亚洲首个比较前生物制剂时代和后生物制剂时代结肠切除术率的ASUC研究，结果显示无显著差异。复发性ASUC的结肠切除术率高于原发性ASUC。

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

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.