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Long-Term Colectomy Rate After Intensive Intravenous Corticosteroid Therapy for Ulcerative Colitis Prior to the Immunosuppressive Treatment Era
Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.
Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.
Unit of Statistics and Epidemiology, Center for Clinical Research, Örebro University Hospital, Örebro, Sweden.
Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.
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2007 (English)In: American Journal of Gastroenterology, ISSN 0002-9270, E-ISSN 1572-0241, Vol. 102, no 11, 2513-2519 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:  Corticosteroids are a cornerstone in the treatment of a severe attack of ulcerative colitis (UC). The long-term prognosis in this patient group is not well described. We studied the long-term colectomy and relapse rates in patients given intensive intravenous corticosteroid treatment (IIVT) for acute UC.

METHODS:  A retrospective clinical study of 158 patients with UC treated in 1975–1982 with IIVT. Patients were followed-up to death, colectomy or last visit.

RESULTS:  A total of 11 patients were excluded due to change of diagnosis (N = 10) or lost to follow-up (N = 1). The indication for index IIVT in the remaining 147 patients was a severe attack (N = 61), a moderately severe attack (N = 45), a mild attack (N = 29) or chronic continuous disease (N = 12). The median (range) duration of follow-up was 173 (4–271) months in patients escaping colectomy during the first 3 months. Three months after IIVT, the colectomy rates were 28/61 (46%) in a severe attack, 4/45 (9%) in a moderately severe, and 1/29 (3%) in a mild attack. After 10 yr, the colectomy rates were 39/61 (64%), 22/45 (49%), and 8/29 (28%), respectively. During follow-up, neither colectomy incidence beyond 3 months, time to first relapse nor relapse incidence was influenced by severity of initial attack, except for a lower relapse incidence after a severe attack.

CONCLUSIONS:  In patients escaping colectomy during the first 3 months after IIVT, the future prognosis was similar irrespective of initial disease severity.

Place, publisher, year, edition, pages
2007. Vol. 102, no 11, 2513-2519 p.
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-40151DOI: 10.1111/j.1572-0241.2007.01435.xLocal ID: 52438OAI: oai:DiVA.org:liu-40151DiVA: diva2:261000
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2012-09-03Bibliographically approved

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Halfvarson, Jonas

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