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Observational Study
. 2020 Jul;50(7):823-829.
doi: 10.1111/imj.14649.

Short-term colectomy is avoided in over half of regional patients failing medical therapy for acute severe ulcerative colitis with co-ordinated transfer and tertiary care

Desmond Patrick  1   2   3 , James D Doecke  4 , James Irwin  2 , Katherine Hanigan  2 , Lisa A Simms  2 , Mariko Howlett  1 , Graham L Radford-Smith  1   2   3
Affiliations
Observational Study

Short-term colectomy is avoided in over half of regional patients failing medical therapy for acute severe ulcerative colitis with co-ordinated transfer and tertiary care

Desmond Patrick et al. Intern Med J. 2020 Jul.

Abstract

Background and aims: Many patients presenting with an acute severe ulcerative colitis to a regional hospital are transferred to a metropolitan hospital for specialised care. This study aimed to evaluate the outcomes and characteristics of these patients.

Method: A retrospective observational cohort study was conducted to examine the 30-day colectomy rate using prospectively collected data on 69 consecutive index cases of acute severe ulcerative colitis transferred from regional hospitals to our metropolitan hospital meeting Truelove and Witts criteria. Those that avoided colectomy were followed out to 1 year to examine outcomes.

Results: The 30-day colectomy rate was 46.4% (32/69) in regional transfer patients. Rescue therapy was administered to 65% (45/69) of patients after transfer to our metropolitan hospital. Colectomy was avoided in 55% of these patients at 30 days. Colectomy free status was maintained in 78% (29/39) of these patients. Mortality was 0% at 30 days and 1 year.

Conclusion: Over 50% of the patients failing therapy in a regional centre and requiring transfer avoided short term colectomy with co-ordinated referral for rescue therapy in a tertiary metropolitan inflammatory bowel disease unit. These patients would have ultimately required colectomy in their regional hospital without intervention.

Keywords: inflammatory bowel disease; outcome assessment; regional and rural; ulcerative colitis.

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References

    1. Stenner JMCWP, Gould SR. Audit of the management of severe ulcerative colitis in a DGH. Gut 2001; 48 (Suppl 1): A87.
    1. Physicians CEaEuatRCo. National Clinical Audit of Inpatient Care for Adults with Ulcerative Colitis UKInflammatory Bowel Disease (IBD) Audit. London, UK: Royal college of physicians; 2014; 1-60.
    1. Nguyen GC, Laveist TA, Gearhart S et al. Racial and geographic variations in colectomy rates among hospitalized ulcerative colitis patients. Clin Gastroenterol Hepatol 2006; 4: 1507-13.
    1. Kotwal S, Ranasinghe I, Brieger D et al. Long-term outcomes of patients with acute myocardial infarction presenting to regional and remote hospitals. Heart Lung Circ 2016; 25: 124-31.
    1. Poulos M. Mortality from Asthma and COPD in Australia. Canberra: Australian Institute for Health and Welfare; 2014.

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