title: Clinical course during the first 10 years of ulcerative colitis: results from a population-based inception cohort (IBSEN Study).
abstract: OBJECTIVE
  Cohort studies of unselected and newly diagnosed patients are essential for a better understanding of the prognosis in ulcerative colitis (UC). The aim of this study was to evaluate the course of UC in a population-based inception cohort during the first 10 years, and to identify prognostic risk factors based on information gathered at diagnosis.
  
  
  METHODS
  From 1990 to 1994, a population-based cohort of 843 patients with inflammatory bowel disease was enrolled in South-Eastern Norway. The cohort was systematically followed-up at 1, 5 and 10 years after diagnosis.
  
  
  RESULTS
  Of 519 patients with UC, 423 completed the 10-year follow-up, 53 died and 43 were lost to follow-up. The mortality risk was not increased compared with that in the general population. The cumulative colectomy rate after 10 years was 9.8% (95% CI: 7.4-12.4%). Initial presentation with extensive colitis and erythrocyte sedimentation rate (ESR) > or =30 mm/h was associated with an increased hazard ratio (HR) (3.57, 95% CI: 1.60-7.96) and age > or =50 years at diagnosis, with reduced HR (0.28, 95% CI: 0.12-0.65) for subsequent colectomy. Relapsing disease was noted in 83%, but half (48%) of the patients were relapse free during the last 5 years. One-fifth (69/288) of patients with proctitis or left-sided colitis had progressed to extensive colitis.
  
  
  CONCLUSIONS
  The prognosis for UC during the first 10 years was generally good. The colectomy rate was low, and a large proportion of patients were in remission as time progressed. Patients with initially extensive colitis and elevated ESR could benefit from an early potent medical treatment strategy.
authors.affiliation: Department of Gastroenterology, Ullevål University Hospital, Oslo, Norway. i.c.solberg@medisin.uio.no
authors.forename: Inger Camilla
authors.initials: IC
authors.lastname: Solberg
authors.forename: Idar
authors.initials: I
authors.lastname: Lygren
authors.forename: Jørgen
authors.initials: J
authors.lastname: Jahnsen
authors.forename: Erling
authors.initials: E
authors.lastname: Aadland
authors.forename: Ole
authors.initials: O
authors.lastname: Høie
authors.forename: Milada
authors.initials: M
authors.lastname: Cvancarova
authors.forename: Tomm
authors.initials: T
authors.lastname: Bernklev
authors.forename: Magne
authors.initials: M
authors.lastname: Henriksen
authors.forename: Jostein
authors.initials: J
authors.lastname: Sauar
authors.forename: Morten H
authors.initials: MH
authors.lastname: Vatn
authors.forename: Bjørn
authors.initials: B
authors.lastname: Moum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult