دورية أكاديمية
Trends in Morbidity and Mortality Following Colectomy Among Patients with Ulcerative Colitis in the Biologic Era (2002-2013): A Study Using the National Inpatient Sample.
العنوان: | Trends in Morbidity and Mortality Following Colectomy Among Patients with Ulcerative Colitis in the Biologic Era (2002-2013): A Study Using the National Inpatient Sample. |
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المؤلفون: | Olaiya B; Department of Internal Medicine, Marshfield Clinic, Marshfield, WI, USA. babatundeolaiya@yahoo.com., Renelus BD; Department of Gastroenterology, Brooklyn Methodist, New York-Presbyterian Hospital, Brooklyn, NY, USA., Filon M; School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA., Saha S; Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA. |
المصدر: | Digestive diseases and sciences [Dig Dis Sci] 2021 Jun; Vol. 66 (6), pp. 2032-2041. Date of Electronic Publication: 2020 Jul 16. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 7902782 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2568 (Electronic) Linking ISSN: 01632116 NLM ISO Abbreviation: Dig Dis Sci Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Science + Business Media Original Publication: New York, Plenum Pub. Corp. |
مواضيع طبية MeSH: | Biological Products/*administration & dosage , Colectomy/*mortality , Colectomy/*trends , Colitis, Ulcerative/*mortality , Databases, Factual/*trends , Mortality/*trends, Adult ; Aged ; Biological Products/economics ; Cohort Studies ; Colectomy/economics ; Colitis, Ulcerative/economics ; Colitis, Ulcerative/therapy ; Databases, Factual/economics ; Female ; Health Care Costs/trends ; Humans ; Inpatients ; Male ; Middle Aged ; Morbidity/trends |
مستخلص: | Background: Total abdominal colectomy (TAC) is a treatment modality of last recourse for patients with severe and/or refractory ulcerative colitis (UC). The goal of this study is to evaluate temporal trends and treatment outcomes following TAC among hospitalized UC patients in the biologic era. Methods: We queried the National Inpatient Sample (NIS) to identify patients older than 18 years with a primary diagnosis of ulcerative colitis (UC) who underwent TAC between 2002 and 2013. We evaluated postoperative morbidity and mortality as outcomes of interest. Logistic regression was used to explore factors associated with postoperative morbidity and mortality after TAC. Results: A weighted total of 307,799 UC hospitalizations were identified. Of these, 27,853 (9%) resulted in TAC. Between 2002 and 2013, hospitalizations for UC increased by over 70%; however, TAC rates dropped significantly from 111.1 to 77.1 colectomies per 1000 UC admissions. Overall, 2.2% of patients died after TAC. Mortality rates after TAC decreased from 3.5% in 2002 to 1.4% in 2013. Conversely, morbidity rates were stable throughout the study period. UC patients with emergent admissions, higher comorbidity scores and who had TAC in low volume colectomy hospitals had poorer outcomes. Regardless of admission type, outcomes were worse if TAC was performed more than 24 h after admission. Conclusions: Despite increased hospitalizations for UC, rates of TAC have declined during the post-biologic era. For UC patients who undergo TAC, mortality has declined significantly while morbidity remains stable. Older age, race, emergent admissions and delayed surgery are predictive factors of both postoperative morbidity and mortality. |
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فهرسة مساهمة: | Keywords: Colectomy; National Inpatient Sample; Ulcerative colitis |
المشرفين على المادة: | 0 (Biological Products) |
تواريخ الأحداث: | Date Created: 20200718 Date Completed: 20210901 Latest Revision: 20220304 |
رمز التحديث: | 20240628 |
DOI: | 10.1007/s10620-020-06474-1 |
PMID: | 32676826 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1573-2568 |
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DOI: | 10.1007/s10620-020-06474-1 |