Colectomy Rates in Ulcerative Colitis Are Low and Decreasing: 10-year-follow-up Data from the Swiss IBD Cohort Study.

TitreColectomy Rates in Ulcerative Colitis Are Low and Decreasing: 10-year-follow-up Data from the Swiss IBD Cohort Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsParragi, L, Fournier, N, Zeitz, J, Scharl, M, Greuter, T, Schreiner, P, Misselwitz, B, Safroneeva, E, Schoepfer, AM, Vavricka, SR, Rogler, G, Biedermann, L
Corporate AuthorsGroup, SIBDCohort
JournalJournal of Crohn's & colitis
Date Published06/2018
Mots-clés80 and over, Adolescent, Adult, Age of Onset, Aged, Child, Colectomy/statistics & numerical data, Colectomy/trends, Colitis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Preschool, Retrospective Studies, Risk Factors, Sex Factors, Switzerland, Ulcerative/complications, Ulcerative/diagnosis, Ulcerative/surgery, Young Adult

Objectives: Previous population-based studies in patients with ulcerative colitis (UC) revealed variable colectomy rates and colectomy-associated risk factors. Over the last two decades, a decrease in colectomy rates was observed. We assessed risk factors and colectomy rates over time in UC in the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS).

Methods: Prospectively-collected SIBDCS data, including disease history, baseline characteristics at enrollment, and course of disease, were retrospectively analyzed. Cumulative and adjusted annual colectomy rates were calculated.

Results: Among 1245 UC patients analyzed (54.6% male), 114 (9.2%) underwent colectomy. We observed 5-, 10-, 15- and 20-year cumulative colectomy rates after diagnosis of 4.1%, 6.4%, 10.4% and 14.4%, respectively. Male sex (odds ratio OR 1.54; p=0.035), pancolitis at diagnosis (OR = 2.16, p=0.005), younger age at diagnosis (OR 0.89 per 5 years of age; p=0.006) and presence of extraintestinal manifestations (EIM; OR 2.30; p<0.001) were risk factors for undergoing colectomy. We did not observe a significant protective effect of smoking on colectomy risk (OR 0.64; p=0.106). The majority of colectomies were performed within first 10 years of disease onset with a rapidly decreasing colectomy rate after 15 years. In patients diagnosed after 2003, colectomy was performed much earlier during individual's disease course. Nevertheless, we found a significantly decreasing trend in yearly colectomy rates over time after 2005.

Conclusion: Crude and adjusted colectomy rates in Swiss UC patients were lower than those reported previously in the literature and decreased over time.

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Alternate JournalJ Crohns Colitis
Citation Key / SERVAL ID8816
Peer reviewRefereed
PubMed ID29617750


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