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. 2022 May 1;117(5):769-776.
doi: 10.14309/ajg.0000000000001685. Epub 2022 Feb 15.

Urgency and Its Association With Quality of Life and Clinical Outcomes in Patients With Ulcerative Colitis

Jared A Sninsky  1   2 , Edward L Barnes  1   2 , Xian Zhang  1   2 , Millie D Long  1   2
Affiliations

Urgency and Its Association With Quality of Life and Clinical Outcomes in Patients With Ulcerative Colitis

Jared A Sninsky et al. Am J Gastroenterol. .

Abstract

Introduction: Urgency, the immediate need to defecate, is common in active ulcerative colitis (UC). We investigated the association of urgency in patients with UC with (i) quality of life (QoL) domains and (ii) future hospitalizations, corticosteroid use, and colectomy for UC.

Methods: We conducted a cross-sectional and subsequent longitudinal study within Inflammatory Bowel Disease Partners, a patient-powered research network. We described associations of levels of urgency in patients with UC with Patient-Reported Outcomes Measurement Information System QoL domains. We conducted a longitudinal cohort to determine associations between baseline urgency and subsequent hospitalization, corticosteroid use, or colectomy for UC within 12 months. We used bivariate statistics and logistic regression models to describe independent associations.

Results: A total of 632 patients with UC were included in the cross-sectional study. After adjusting for clinical variables, rectal bleeding, and stool frequency, urgency defined as "hurry," "immediately," and "incontinence" increased the odds of social impairment (odds ratio [OR] 2.05 95% confidence interval [CI] 1.24-3.4, OR 2.76 95% CI 1.1-6.74, and OR 7.7 95% CI 1.66-38.3, respectively) compared with "no hurry." Urgency also significantly increased the odds of depression, anxiety, and fatigue. Urgency was associated with a significant increase in risk of hospitalizations and corticosteroids, whereas "hurry," "immediately," and "incontinence" increased the odds of colectomy within 12 months by 1.42 (1.15-1.75), 1.90 (1.45-2.50), and 3.69 (2.35-5.80).

Discussion: We demonstrated that urgency is a patient-reported outcome independently associated with compromised QoL and future risk of hospitalizations, corticosteroids, and colectomy. Our findings support the consideration of urgency as a UC-specific patient-reported outcome and its use as an outcome in clinical trials to capture QoL and risk of clinical decompensation.

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Figures

Figure 1.
Figure 1.. Longitudinal outcomes associated with baseline level of urgency among patients in IBD Partners with ulcerative colitis
Colectomy: interval report of colectomy per patient; Corticosteroids: interval reported corticosteroid use; Hospitalization: interval UC-related hospitalization; all clinical events within 12 months of symptom report
See this image and copyright information in PMC

References

    1. Rao SS, Holdsworth CD, Read NW. Symptoms and stool patterns in patients with ulcerative colitis. Gut 1988;29(3):342 doi: 10.1136/gut.29.3.342[published Online First: Epub Date]. - DOI - PMC - PubMed
    1. Hibi T, Ishibashi T, Ikenoue Y, Yoshihara R, Nihei A, Kobayashi T. Ulcerative Colitis: Disease Burden, Impact on Daily Life, and Reluctance to Consult Medical Professionals: Results from a Japanese Internet Survey. Inflammatory Intestinal Diseases 2020;5(1):27–35 doi: 10.1159/000505092[published Online First: Epub Date]. - DOI - PMC - PubMed
    1. Rasmussen B, Haastrup P, Wehberg S, Kjeldsen J, Waldorff FB. Predictors of health-related quality of life in patients with moderate to severely active ulcerative colitis receiving biological therapy. Scand J Gastroenterol 2020;55(6):656–63 doi: 10.1080/00365521.2020.1768282[published Online First: Epub Date]. - DOI - PubMed
    1. Hanauer SB, Present DH, Rubin DT. Emerging issues in ulcerative colitis and ulcerative proctitis: individualizing treatment to maximize outcomes. Gastroenterol Hepatol (N Y) 2009;5(6 Suppl):4–16 - PMC - PubMed
    1. Walmsley RS, Ayres RC, Pounder RE, Allan RN. A simple clinical colitis activity index. Gut 1998;43(1):29–32 doi: 10.1136/gut.43.1.29[published Online First: Epub Date]. - DOI - PMC - PubMed

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