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Article: Natural History of Elderly-onset Ulcerative Colitis: Results from a Territory-wide Inflammatory Bowel Disease Registry

TitleNatural History of Elderly-onset Ulcerative Colitis: Results from a Territory-wide Inflammatory Bowel Disease Registry
Authors
Issue Date2016
Citation
Journal of Crohn's and Colitis, 2016, v. 10, p. 176-185 How to Cite?
AbstractBACKGROUND AND AIMS: Data on the natural history of elderly-onset ulcerative colitis [UC] are limited. We aimed to investigate clinical features and outcomes of patients with elderly-onset UC. METHODS: Patients with a confirmed diagnosis of UC between 1981 and 2013, from 13 hospitals within a territory-wide Hong Kong Inflammatory Bowel Disease Registry, were included. Clinical features and outcomes of elderly-onset patients, defined as age ≥ 60 years at diagnosis, were compared with those of non-elderly-onset disease [< 60 years at diagnosis]. RESULTS: We identified 1225 patients, of whom 12.8% [157/1225; 56.1% male] had elderly-onset UC. Median duration of follow-up was 11 years [interquartile range, 6-16 years]. Age-specific incidence of elderly-onset UC increased from 0.1 per 100000 persons before 1991 to 1.3 per 100000 persons after 2010. There were more ex-smokers [32.2% vs. 12.2%, p < 0.001] and higher proportion of comorbidities [p < 0.001] in elderly-onset than non-elderly-onset patients. Disease extent, corticosteroids, immunosuppressants use, and colectomy rates were similar between the two groups. Elderly-onset disease was an independent risk factor for cytomegalovirus infection [odds ratio 2.9, 95% confidence interval 1.6-5.2, p < 0.001]. More elderly-onset patients had Clostridium difficile infection [11.0% vs. 5.4%, p = 0.007], hospitalisation for UC exacerbation [50.6% vs. 41.8%, p = 0.037], colorectal cancer [3.2% vs. 0.9%, p = 0.033], all-cause mortality [7.0% vs. 1.0%, p < 0.001], and UC-related mortality [1.9% vs. 0.2%, p = 0.017] than non-elderly-onset patients. CONCLUSIONS: Elderly-onset UC patients are increasing in number. These patients have higher risk of opportunistic infections, hospitalisation, colorectal cancer, and mortality than non-elderly-onset patients. Management and therapeutic strategies in this special group need careful attention.
Persistent Identifierhttp://hdl.handle.net/10722/226336

 

DC FieldValueLanguage
dc.contributor.authorShi, HY-
dc.contributor.authorChan, FK-
dc.contributor.authorLeung, WK-
dc.contributor.authorLi, MKK-
dc.contributor.authorLeung, CM-
dc.contributor.authorSze, SF-
dc.contributor.authorChing, JYL-
dc.contributor.authorLo, FH-
dc.contributor.authorTsang, SWC-
dc.contributor.authorShan, EHS-
dc.contributor.authorMak, LY-
dc.contributor.authorLam, BCY-
dc.contributor.authorHui, AJ-
dc.contributor.authorWong, SH-
dc.contributor.authorWong, MTL-
dc.contributor.authorHung, FNI-
dc.contributor.authorHui, YT-
dc.contributor.authorChan, YK-
dc.contributor.authorChan, KH-
dc.contributor.authorLoo, CK-
dc.contributor.authorTong, RWH-
dc.contributor.authorChow, WH-
dc.contributor.authorNg, CKM-
dc.contributor.authorLao, WC-
dc.contributor.authorHarbord, M-
dc.contributor.authorWu, JCY-
dc.contributor.authorSung, JJY-
dc.contributor.authorNg, SC-
dc.date.accessioned2016-06-17T07:43:27Z-
dc.date.available2016-06-17T07:43:27Z-
dc.date.issued2016-
dc.identifier.citationJournal of Crohn's and Colitis, 2016, v. 10, p. 176-185-
dc.identifier.urihttp://hdl.handle.net/10722/226336-
dc.description.abstractBACKGROUND AND AIMS: Data on the natural history of elderly-onset ulcerative colitis [UC] are limited. We aimed to investigate clinical features and outcomes of patients with elderly-onset UC. METHODS: Patients with a confirmed diagnosis of UC between 1981 and 2013, from 13 hospitals within a territory-wide Hong Kong Inflammatory Bowel Disease Registry, were included. Clinical features and outcomes of elderly-onset patients, defined as age ≥ 60 years at diagnosis, were compared with those of non-elderly-onset disease [< 60 years at diagnosis]. RESULTS: We identified 1225 patients, of whom 12.8% [157/1225; 56.1% male] had elderly-onset UC. Median duration of follow-up was 11 years [interquartile range, 6-16 years]. Age-specific incidence of elderly-onset UC increased from 0.1 per 100000 persons before 1991 to 1.3 per 100000 persons after 2010. There were more ex-smokers [32.2% vs. 12.2%, p < 0.001] and higher proportion of comorbidities [p < 0.001] in elderly-onset than non-elderly-onset patients. Disease extent, corticosteroids, immunosuppressants use, and colectomy rates were similar between the two groups. Elderly-onset disease was an independent risk factor for cytomegalovirus infection [odds ratio 2.9, 95% confidence interval 1.6-5.2, p < 0.001]. More elderly-onset patients had Clostridium difficile infection [11.0% vs. 5.4%, p = 0.007], hospitalisation for UC exacerbation [50.6% vs. 41.8%, p = 0.037], colorectal cancer [3.2% vs. 0.9%, p = 0.033], all-cause mortality [7.0% vs. 1.0%, p < 0.001], and UC-related mortality [1.9% vs. 0.2%, p = 0.017] than non-elderly-onset patients. CONCLUSIONS: Elderly-onset UC patients are increasing in number. These patients have higher risk of opportunistic infections, hospitalisation, colorectal cancer, and mortality than non-elderly-onset patients. Management and therapeutic strategies in this special group need careful attention.-
dc.languageeng-
dc.relation.ispartofJournal of Crohn's and Colitis-
dc.titleNatural History of Elderly-onset Ulcerative Colitis: Results from a Territory-wide Inflammatory Bowel Disease Registry-
dc.typeArticle-
dc.identifier.emailLeung, WK: waikleung@hku.hk-
dc.identifier.emailHung, FNI: ivanhung@hkucc.hku.hk-
dc.identifier.authorityLeung, WK=rp01479-
dc.identifier.authorityHung, FNI=rp00508-
dc.identifier.doi10.1093/ecco-jcc/jjv194-
dc.identifier.hkuros258126-
dc.identifier.volume10-
dc.identifier.spage176-
dc.identifier.epage185-

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