The outcomes of emergency admissions with ulcerative colitis between 2007 and 2017 in England

Dominic King, James Rees, Jemma Mytton, Philip Harvey, Tom Thomas, Rachael Cooney, Prashant Patel, Nigel Trudgill

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

BACKGROUND AND AIMS: Patients with Ulcerative Colitis (UC) may present as emergencies and require rapid escalation of therapy. This study aimed to assess the mortality, colectomy and readmission risk during and following a first emergency admission with UC.

METHODS: Using Hospital Episode Statistics, subjects aged between 18-60 years, coded with a first emergency admission with UC were identified between 2007-2017. Influences of demographic factors, comorbidity, anti-TNF therapy and provider UC activity on mortality and colectomy were examined.

RESULTS: 10,051 subjects (46% female; median age 33-years (IQR 25-44)) were identified. Mortality was 0.2% in-hospital and 0.5% at 12-months, and following colectomy during acute admission was 1.4% in-hospital and 2.1% at 12-months. Females had reduced risk of colectomy during admission (OR 0.73 (95%CI 0.62-0.85)). Comparing the period from 2007-2011 to 2012-2017, the rate of colectomy fell during acute admissions, OR 0.85 (0.72-0.99), p=0.038 and at 12-months after admission OR 0.73 (0.61-0.87). Anti-TNF therapy increased four-fold in acute UC admissions from 2007-2017. Those receiving anti-TNF therapy had a 70% increased risk of colectomy during index admission compared to those not receiving anti-TNF (OR 1.72 (1.29-2.31)). Increased time to colectomy during first admission was associated with female sex (HR 0.84 (0.72-0.98)) and Asian ethnicity (HR 0.61 (0.44-0.85)) while reduced time was associated with increased comorbidity, lower deprivation and high provider volume of colectomies for UC (HR 1.59 (1.31-1.93)).

CONCLUSIONS: Mortality following colectomy was 1.4% in-hospital, 2.1% at 12-months, and no significant change over time was observed. Colectomy during emergency admission for UC was less common in females. Rates of anti-TNF therapy during emergency admission for UC have increased whereas overall colectomy rates have fallen.

Original languageEnglish
JournalJournal of Crohn's & Colitis
Early online date12 Nov 2019
DOIs
Publication statusE-pub ahead of print - 12 Nov 2019

Keywords

  • Inflammatory bowel disease
  • ulcerative colitis
  • colectomy

Fingerprint

Dive into the research topics of 'The outcomes of emergency admissions with ulcerative colitis between 2007 and 2017 in England'. Together they form a unique fingerprint.

Cite this