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.
Full article: http://dx.doi.org/10.1093/ecco-jcc/jjv194