Open AccessRisk factors for complications in patients with ulcerative colitis
Author(s) -
Manser Christine N,
Borovicka Jan,
Seibold Frank,
Vavricka Stephan R,
Lakatos Peter L,
Fried Michael,
Rogler Gerhard
Publication year - 2016
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640615627533
Subject(s) - medicine , ulcerative colitis , inflammatory bowel disease , odds ratio , erythema nodosum , malabsorption , gastroenterology , primary sclerosing cholangitis , sulfasalazine , confidence interval , prospective cohort study , disease , surgery
Background Patients with ulcerative colitis may develop extraintestinal manifestations like erythema nodosum or primary sclerosing cholangitis or extraintestinal complications like anaemia, malabsorption or they may have to undergo surgery. Objective The aim of this study was to investigate potential risk factors for complications like anaemia, malabsorption or surgery in ulcerative colitis. Methods Data on 179 patients with ulcerative colitis were retrieved from our cross‐sectional and prospective Swiss Inflammatory Bowel Disease Cohort Study data base for a median observational time of 4.2 years. Data were compared between patients with ( n = 140) or without ( n = 39) complications. Gender, age at diagnosis, smoking status, disease extent, delay of diagnosis or therapy, mesalamine (5‐ASA) systemic and topical therapy, as well as other medication were analysed as potential impact factors. Results In the multivariate regression analysis a delay of 5‐ASA treatment by at least two months (odds ratio (OR) 6.21 (95% confidence interval (CI) 2.13–18.14), p = 0.001) as well as a delay with other medication with thiopurines (OR 6.48 (95% CI 2.01–20.91), p = 0.002) were associated with a higher risk for complications. This significant impact of a delay of 5‐ASA therapy was demonstrated for extraintestinal manifestations (EIMs) as well as extraintestinal complications (EICs). Extensive disease as well as therapy with methotrexate showed a significantly increased risk for surgery (extensive disease: OR 2.62 (1.02–6.73), p = 0.05, methotrexate: OR 5.36 (1.64–17.58), p = 0.006). Conclusions A delay of 5‐ASA therapy of more than two months in the early stage of ulcerative colitis (UC) constitutes a risk for complications during disease course. Extensive disease is associated with a higher risk for surgery.