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Risk Factors and Indications for Colectomy in Ulcerative Colitis Patients are Different According to Patient’s Clinical Background

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Diseases of the Colon & Rectum

Purpose

Despite progress in medical treatment for ulcerative colitis, a considerable fraction of ulcerative colitis patients undergo colectomy. We analyzed the clinical variables of ulcerative colitis patients and determined the risk factors and indications for colectomy.

Methods

The clinical records of 981 consecutive Japanese patients with ulcerative colitis were reviewed both retrospectively and prospectively.

Results

Of 981 patients with ulcerative colitis, 85 patients underwent colectomy. Multivariate analysis indicated that male gender (risk ratio, 2.16; 95 percent confidence interval, 1.37–3.42), onset year during and after 2000 (risk ratio, 2.85; 95 percent confidence interval, 1.31–6.22), severe disease activity (risk ratio, 2; 95 percent confidence interval, 1.15–3.48), corticosteroid resistance (risk ratio, 7.05; 95 percent confidence interval, 4.29–11.59), and complications because of corticosteroid administration (risk ratio, 3.55; 95 percent confidence interval, 2.08–6.06) were significant risk factors for colectomy. In patients with disease duration of more than five years, only corticosteroid resistance and complications because of corticosteroid were significant risk factors for colectomy. When we stratified indications for colectomy for the 85 cases via patient disease duration, massive hemorrhage was a relatively frequent cause of colectomy in patients with a disease duration of less than five years (P = 0.091). On the other hand, colon dysplasia or cancer was a major cause for colectomy in patients with a disease duration of more than ten years (P = 0.0001).

Conclusions

In ulcerative colitis patients, the risk factors and indications for colectomy were different according to the patient's clinical background. Our findings may help to predict patients with ulcerative colitis who have a high risk for colectomy.

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Authors and Affiliations

  1. Department of Gastroenterology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan

    Motoaki Kuriyama M.D., Jun Kato M.D., Ph.D., Hiroyuki Okada M.D., Ph.D. & Yasushi Shiratori M.D., Ph.D.

  2. Department of Internal Medicine, Tsuyama Central Hospital, Okayama, Japan

    Tsuyoshi Fujimoto M.D.

  3. Department of Internal Medicine, National Shikoku Cancer Center, Ehime, Japan

    Junichirou Nasu M.D., Ph.D.

  4. Department of Internal Medicine, Saiseikai Imabari Hospital, Ehime, Japan

    Jiro Miyaike M.D., Ph.D.

  5. Department of Internal Medicine, Fukuyama City Hospital, Hiroshima, Japan

    Takechiyo Morita M.D., Ph.D.

  6. Department of Internal Medicine, Sumitomo Beshi Hospital, Ehime, Japan

    Seiyuu Suzuki M.D., Ph.D.

  7. Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan

    Junji Shiode M.D., Ph.D.

  8. Department of Internal Medicine, Kurashiki Central Hospital, Okayama, Japan

    Hiroshi Yamamoto M.D., Ph.D.

  9. Department of Gastroenterology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan

    Jun Kato M.D., Ph.D.

Authors
  1. Motoaki Kuriyama M.D.
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  2. Jun Kato M.D., Ph.D.
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  3. Tsuyoshi Fujimoto M.D.
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  4. Junichirou Nasu M.D., Ph.D.
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  5. Jiro Miyaike M.D., Ph.D.
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  6. Takechiyo Morita M.D., Ph.D.
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  7. Hiroyuki Okada M.D., Ph.D.
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  8. Seiyuu Suzuki M.D., Ph.D.
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  9. Junji Shiode M.D., Ph.D.
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  10. Hiroshi Yamamoto M.D., Ph.D.
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  11. Yasushi Shiratori M.D., Ph.D.
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Consortia

Japan West Ulcerative Colitis (JWUC) Study Group

Corresponding author

Correspondence to Jun Kato M.D., Ph.D..

Appendix

Appendix

In addition to the authors, the members of the JWUC study group were as follows: M. Watou, Kagawa Prefectural Central Hospital, Kagawa; J. Tomoda, Fukuyama Medical Center, Hiroshima; T. Ota, Iwakuni Medical Center, Yamaguchi; H. Morishita, Himeji Red Cross Hospital, Hyogo; N. Okano, Hiroshima City Hospital, Hiroshima; T. Nawa, Mitoyo General Hospital, Kagawa; Y. Nagahara, Nippon Kokan Fukuyama Hospital, Hiroshima; M. Sotozono, Ritsurin Hospital, Kagawa; F. Yoshinaga, Mihara Red Cross Hospital, Hiroshima; S. Takagi, Izumo Municipal General Medical Center, Shimane; M. Nishimura, Okayama City Hospital, Okayama; M. Kawata, Kagawa Saiseikai Hospital, Kagawa; R. Nasu, Kurashiki Riverside Hospital, Okayamya; Y. Kihara, Hiroshima Teishin Hospital, Hiroshima; A. Takahashi, Bizen Hospital, Okayama; all institutes were located in Japan.

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Kuriyama, M., Kato, J., Fujimoto, T. et al. Risk Factors and Indications for Colectomy in Ulcerative Colitis Patients are Different According to Patient’s Clinical Background. Dis Colon Rectum 49, 1307–1315 (2006). https://doi.org/10.1007/s10350-006-0574-6

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  • DOI: https://doi.org/10.1007/s10350-006-0574-6

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