Comparing the clinical outcomes of young-onset and adult-onset ulcerative colitis: a multi-center Korean Association for the Study for Intestinal Diseases study.
- Author:
Ji Yeon KIM
1
;
Dong Il PARK
;
Dong Soo HAN
;
Kyu Chan HUH
;
Chang Kyun LEE
;
Jeong Eun SHIN
;
Jae Hak KIM
;
You Sun KIM
;
Yunho JUNG
;
Sung Ae JUNG
;
Hyun Joo SONG
;
Hyun Joo JANG
;
Young Ho KIM
;
Sung No HONG
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Colitis, ulcerative; Young-onset; Clinical feature; Outcome
- MeSH: Age of Onset; Body Mass Index; Colitis, Ulcerative*; Humans; Infliximab; Intestinal Diseases*; Korea; Multivariate Analysis; Retrospective Studies; Steroids; Tertiary Care Centers; Ulcer*
- From:The Korean Journal of Internal Medicine 2017;32(1):69-78
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The aim of this study was to compare the clinical features and outcomes of ulcerative colitis (UC) according to the age of onset in Korea. METHODS: A total of 1,141 patients who were diagnosed with UC between July 1987 and November 2013 at 11 tertiary hospitals were enrolled. The baseline disease characteristic and disease state at onset, treatment during the disease course were retrospectively reviewed among patients with young-onset (YO, < 20 years) and adult-onset (AO, ≥ 20 years). Severe outcome was defined as use of intravenous (IV) steroids, infliximab, immunosuppressant, or UC-related operation. RESULTS: There were 55 YO patients (mean age, 17.8 ± 2.4) and 1,086 AO patients (mean age, 43.0 ± 13.6). High Mayo scores (7.7 ± 3.0 vs. 5.6 ± 2.7, p = 0.000), extensive UC (52.7% vs. 25.8%, p = 0.000) and IV steroid (41.8% vs. 18.0%, p = 0.000), immunosuppressant (47.3% vs. 26.9%, p = 0.002), and infliximab (20.0% vs. 7.2%, p = 0.001) use were more frequent in the YO than in the AO group. According to multivariate analysis, severe outcomes were related to YO disease (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.27 to 3.71), body mass index < 23 kg/m² (HR, 1.46; 95% CI, 1.07 to 2.00), severe (HR, 2.29; 95% CI, 1.36 to 3.38), and moderate (HR, 2.48; 95% CI, 1.67 to 3.67) disease, extensive UC (HR, 2.90; 95% CI, 1.79 to 4.69), UC-related admission (HR, 63.89; 95% CI, 20.41 to 200.02), and oral steroid use (HR, 0.51; 95% CI, 0.39 to 0.67). CONCLUSIONS: UC with YO presented with more advanced clinical features at onset and more severe outcomes than the AO. YO cases require careful management and intense treatment strategies.
