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Natural History of Elderly-Onset Ulcerative Colitis: Results from a Territory-Wide Inflammatory Bowe

HY Shi, FK Chan, WK Leung, MK Li, CM Leung, SF Sze, JY Ching, FH Lo, SW Tsang, EH Shan, LY Mak, BC Lam, AJ Hui, SH Wong, MT Wong, IF Hung, YT Hui, YK Chan, KH Chan, CK Loo, RW Tong, WH Chow, CK Ng, WC Lao, M Harbord, JC Wu, JJ Sung, and SC Ng, Journal of Crohn's and colitis. 02, 2016. 10: p. 176-185. [IF: 5.813]

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. We identified 1225 patients with a confirmed diagnosis of UC between 1981 and 2013, from 13 hospitals within a territory-wide Hong Kong Inflammatory Bowel Disease Registry, 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 and higher proportion of comorbidities 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. More elderly-onset patients had Clostridium difficile infection, hospitalisation for UC exacerbation, colorectal cancer, all-cause mortality, and UC-related mortality than non-elderly-onset patients. 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.

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