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Older adults with acute severe ulcerative colitis have similar steroid non-response and colectomy rates as younger adults. | LitMetric

AI Article Synopsis

  • * It includes data from 226 ASUC episodes, with 45 episodes in patients aged 60 and over, and finds that older adults have similar steroid non-response rates compared to younger patients.
  • * The rates of response to medical rescue therapy and the need for colectomy during the hospital stay and at 3 and 12 months follow-up are also comparable between the two age groups.

Article Abstract

Background: There is paucity of data on outcomes of acute severe ulcerative colitis (ASUC) in older adults (≥ 60 years of age).

Aim: To assess steroid non-response rates during the index admission for ASUC in older adults. Secondary outcomes were response to medical rescue therapy and colectomy rates; at index admission, 3 and 12 mo.

Methods: This retrospective multicentre cohort study included ASUC admissions who received intravenous steroids between January 2013 and July 2020 at two tertiary hospitals. Electronic medical records were reviewed to collect clinical, biochemical, and endoscopic data. A modified Poisson regression model was used for analysis.

Results: Of 226 ASUC episodes, 45 (19.9%) occurred in patients ≥ 60 years of age. Steroid non-response rates were comparable in older adults and patients < 60 years of age [19 (42.2%) 85 (47%), = 0.618, crude risk ratio (RR) = 0.89 [95% confidence interval (CI): 0.61-1.30], adjusted RR = 0.99 (0.44-2.21). Rates of response to medical rescue therapy in older adults was comparable to the younger cohort [76.5% 85.7%, = 0.46, crude RR = 0.89 (0.67-1.17)]. Index admission colectomy [13.3% 10.5%, = 0.598, crude RR = 1.27 (0.53-2.99), adjusted RR = 1.43 (0.34-6.06)], colectomy at 3 mo [20% 16.6%, = 0.66, crude RR = 1.18 (0.61-2.3), adjusted RR = 1.31 (0.32-0.53)] and colectomy at 12 mo [20% 23.2%, = 0.682, crude RR = 0.85 (0.45-1.57), adjusted RR = 1.21 (0.29-4.97)], were similar between the two groups.

Conclusion: In older adults with ASUC, the steroid non-response rate, response to medical rescue therapy, and colectomy rate at index admission, 3 and 12 mo is similar to patients less than 60 years of age.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167901PMC
http://dx.doi.org/10.3748/wjg.v29.i16.2469DOI Listing

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