Analysis of risk factors for short-term surgery in acute severe ulcerative colitis
10.3760/cma.j.cn101480-20240228-00030
- VernacularTitle:急性重度溃疡性结肠炎短期手术风险因素分析
- Author:
Aihemaiti DILIAREMU
1
;
Na LI
;
Mei YE
Author Information
1. 武汉大学中南医院消化内科，武汉 430071
- Publication Type:Journal Article
- Keywords:
Acute severe ulcerative colitis;
Surgery, short-term;
Risk factors;
C-reactive protein;
Old age;
Ulcerative colitis endoscopic index of severity
- From:
Chinese Journal of Inflammatory Bowel Diseases
2025;09(1):53-58
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors for short-term surgery in patients with acute severe ulcerative colitis (ASUC) .Methods:A retrospective case-control study was conducted. Consecutive patients with ASUC admitted to the Department of Gastroenterology at Zhongnan Hospital of Wuhan University from January 2019 to June 2023 were enrolled. Clinical data such as general information, clinical manifestations, laboratory tests, and colonoscopy examinations were analyzed. Based on whether the patients underwent surgery within 90 days after admission, the patients were divided into short-term surgery group and short-term non-surgery group, and the differences in clinical characteristics between the two groups were compared. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for short-term surgery.Results:A total of 90 patients were included, with 58 males and 32 females, age 42.0 (30.8, 54.3) years, disease duration 1.00 (0.15, 4.25) years, body mass index (21.4 ± 3.8) kg/m 2; according to the ulcerative colitis endoscopic index of severity (UCEIS) results of 83 patients, 31 were moderate activity, and 52 were severe activity. After a follow-up period of 8.4 (3.9, 14.7) months, a total of 15 patients (16.7%) underwent surgery. Ten patients undergoing surgery within 90 days after admission were set as the short-term surgery group ( n = 10), and 5 patients undergoing surgery more than 90 days after admission and 75 receiving drug treatment were set as the short-term non-surgery group ( n = 80). Compared with the short-term non-surgery group, patients in the short-term surgery group were older, and had a higher proportion of UCEIS 7-8 points and lower remission rates induced by glucocorticoids and biological agents, with all differences being statistically significant (all P < 0.05). Univariate and multivariate Logistic regression analyses found that age ≥55 years ( P = 0.009, OR = 13.266, 95% CI: 1.922-91.548) and high baseline CRP ( P = 0.014, OR = 1.010, 95% CI: 1.002-1.019) were independent risk factors for short-term surgery in ASUC patients. Postoperative complications occurred in 4 patients, including 1 of anastomotic ulceration, 1 of ileostomy infection, and 2 of pouchitis. Conclusion:The surgery rate in ASUC patients is high, and patients who are older or have elevated CRP are more likely to undergo short-term surgery.
