¿Ha disminuido la colectomía por crisis de colitis ulcerosa? / Has colectomy for moderate-severe active ulcerative colitis decreased?
Rev. méd. Chile
; 151(3): 313-320, mar. 2023. tab, graf
Article
en Es
| LILACS
| ID: biblio-1530256
Biblioteca responsable:
CL126.2
RESUMEN
BACKGROUND:
Treatment for moderate-severe active ulcerative colitis (UC) includes steroids, biologic therapy and total colectomy.Aim:
To describe the features of patients with moderate to severe active UC, their hospital evolution and need for colectomy. MATERIAL ANDMETHODS:
Non-concurrent cohort study of all patients admitted to our institution with a diagnosis of moderate or severe UC crisis between January 2008 and May 2019. Truelove Witts (TW) criteria were used to categorize disease severity. Twelve-month colectomy-free survival was estimated with Kaplan-Meier survival analysis.Results:
One hundred-twenty patients aged 16 to 89 (median 35) years had 160 admissions for acute moderate to severe UC. Median admission per patient was 1 (1-3), and median hospital stay was six days (1-49). Cytomegalovirus and Clostridioides difficile were found in 17.5 and 14.2% of crises, respectively. Corticosteroids were used in all crises and biologic therapy in 6.9% of them. Emergency or elective colectomies were performed in 18.3 and 6.7% of patients, respectively. The need for emergency total colectomy decreased from 24.6 to 7.8% (Risk ratio 3.16, p < 0.01) between de first and second half of the study period. Kaplan-Meier analysis for long term colectomy-free survival in both periods confirmed this decrease (p < 0.01).CONCLUSIONS:
Medical treatment for moderate to severe UC crises had a 86.3% success and a small percentage required emergency total colectomy. Emergency surgery decreased in the last decade.Palabras clave
Texto completo:
1
Índice:
LILACS
Asunto principal:
Colitis Ulcerosa
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
Es
Revista:
Rev. méd. Chile
Asunto de la revista:
MEDICINA
Año:
2023
Tipo del documento:
Article