Severity of Inflammation as a Predictor of Colectomy in Patients With Chronic Ulcerative Colitis

Marco M HEFTI; David B CHESSIN; Noam HARPAZ; Randolph M STEINHAGEN; Thomas A ULLMAN

doi:10.1007/DCR.0b013e31819ad456

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Severity of Inflammation as a Predictor of Colectomy in Patients With Chronic Ulcerative Colitis

Journal article

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Severity of Inflammation as a Predictor of Colectomy in Patients With Chronic Ulcerative Colitis

Marco M HEFTI, David B CHESSIN, Noam HARPAZ, Randolph M STEINHAGEN and Thomas A ULLMAN

Diseases of the colon & rectum, Vol.52(2), pp.193-197

2009

DOI: 10.1007/DCR.0b013e31819ad456

PMCID: PMC2753491

PMID: 19279411

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https://www.ncbi.nlm.nih.gov/pmc/articles/2753491View

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Abstract

Purpose: We evaluated a large cohort of patients with longstanding ulcerative colitis in a colonoscopic surveillance program to determine predictors of colectomy. Methods: We queried a retrospective database of patients who had symptoms of ulcerative colitis for seven years or more. Histologic inflammation in biopsies was graded on a validated four-point scale: absent, mild, moderate, severe. We performed a multivariate analysis of the inflammation scores and other variables to determine predictive factors for colectomy. Patients who underwent colectomy for neoplasia were censored at the time of surgery; those who did not undergo colectomy were censored at the time of last contact. Results: A total of 561 patients were evaluated, with a median follow-up of 21.4 years since disease onset. A total of 97 patients (17.3 percent) underwent surgery; 25 (4.5 percent) for reasons other than dysplasia. These 25 constitute events for this analysis. For univariate analysis, mean inflammation (P < 0.001) and steroid use (P = 0.01) were predictors of colectomy. For multivariable proportional hazards analysis, mean inflammation (P < 0.001) and steroid use (P = 0.03) were predictors of colectomy, whereas salicylate use (P = 0.007) was protective. Conclusions: Higher median inflammation scores and corticosteroid use were predictors of colectomy in this patient population. The overall rate of colectomy during a long period of follow-up was low (<1 percent per year).

Gastroenterology. Liver. Pancreas. Abdomen

Stomach. Duodenum. Small intestine. Colon. Rectum. Anus

Biological and medical sciences

Medical sciences

Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases

Surgery of the digestive system

Stomach, duodenum, intestine, rectum, anus

Other diseases. Semiology

Details

Title: Subtitle: Severity of Inflammation as a Predictor of Colectomy in Patients With Chronic Ulcerative Colitis
Creators: Marco M HEFTI - Department of Surgery, Mount Sinai School of Medicine, New York, New York, United States
David B CHESSIN - Department of Surgery, Mount Sinai School of Medicine, New York, New York, United States
Noam HARPAZ - Department of Pathology, Mount Sinai School of Medicine, New York, New York, United States
Randolph M STEINHAGEN - Department of Surgery, Mount Sinai School of Medicine, New York, New York, United States
Thomas A ULLMAN - Department of Medicine, Mount Sinai School of Medicine, New York, New York, United States
Resource Type: Journal article
Publication Details: Diseases of the colon & rectum, Vol.52(2), pp.193-197
DOI: 10.1007/DCR.0b013e31819ad456
PMID: 19279411
PMCID: PMC2753491
NLM abbreviation: Dis Colon Rectum
ISSN: 0012-3706
eISSN: 1530-0358
Publisher: Lippincott Williams & Wilkins; Hagerstown, MDc
Language: English
Date published: 2009
Academic Unit: Pathology; Iowa Neuroscience Institute
Record Identifier: 9984047732302771

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