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Ha disminuido la colectomía por crisis de colitis ulcerosa?

Revista medíca de Chile, 2023-03, Vol.151 (3), p.313-320 [Peer Reviewed Journal]

This work is licensed under a Creative Commons Attribution 4.0 International License. ;ISSN: 0034-9887 ;EISSN: 0717-6163 ;DOI: 10.4067/s0034-98872023000300313

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  • Title:
    Ha disminuido la colectomía por crisis de colitis ulcerosa?
  • Author: Besser, Nicolás ; Chacón, Erika ; Iglesias, Andrés ; Álvarez-Lobos, Manuel ; Pavez, Carolina ; Villalón, Constanza ; Urrejola, Gonzalo ; Zúñiga, Álvaro ; Molina, María Elena ; Miguieles, Rodrigo ; Bellolio, Felipe
  • Subjects: MEDICINE, GENERAL & INTERNAL
  • Is Part Of: Revista medíca de Chile, 2023-03, Vol.151 (3), p.313-320
  • Description: 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 and Methods: 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.
  • Publisher: Sociedad Médica de Santiago
  • Language: English;Portuguese
  • Identifier: ISSN: 0034-9887
    EISSN: 0717-6163
    DOI: 10.4067/s0034-98872023000300313
  • Source: SciELO
    GFMER Free Medical Journals
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