title: Cumulative incidence and risk factors for hospitalization and surgery in a population-based cohort of ulcerative colitis.
abstract: BACKGROUND
  We sought to identify clinical and demographic features influencing hospitalization and colectomy in a population-based inception cohort of ulcerative colitis.
  
  
  METHODS
  Between 1970 and 2004, a total of 369 patients (58.5% males) from Olmsted County, MN, were followed from diagnosis for 5401 person-years. The cumulative probability of hospitalization and colectomy were estimated using the Kaplan-Meier method. Cox proportional hazards regression was used to identify factors associated with hospitalization and colectomy.
  
  
  RESULTS
  The cumulative probability of first hospitalization was 29.4% at 5 years (95% confidence interval [CI], 24.5%-34.1%), 38.7% at 10 years (33.1%-43.8%), 49.2% at 20 years (42.7%-55.2%), and 52.3% at 30 years (45.1%-59.7%). The incidence rate of hospitalizations decreased over the last 4 decades, although cumulative probability of first hospitalization increased with successive decades of diagnosis. Early need for corticosteroids (hazard ratio [HR], 1.8; 95% CI, 1.1%-2.7%) and early need for hospitalization (HR, 1.5; 95% CI, 1.02-2.4) were independent predictors of hospitalization after 90 days of illness. The cumulative probability of colectomy from the time of diagnosis was 13.1% at 5 years (95% CI, 9.4%-16.6%), 18.9% at 10 years (95% CI, 14.4%-23.2%), and 25.4% at 20 years (95% CI, 19.8%-30.8%). Male gender (HR, 2.1; 95% CI, 1.3-3.5), diagnosis in the 1990s (HR, 2.0; 95% CI, 1.01-4.0), and diagnosis in 2000 to 2004 (HR, 3.7; 95% CI, 1.7-8.2) were significantly associated with colectomy risk.
  
  
  CONCLUSIONS
  Colectomy rates were comparable to reports from northern Europe. The numbers of hospitalizations show a decreasing trend. Male gender and being diagnosed in the 2000 to 2004 period predicted colectomy while extensive colitis predicted future hospitalizations.
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.
authors: Sunil
authors: S
authors: Samuel
authors: Steven B
authors: SB
authors: Ingle
authors: Shamina
authors: S
authors: Dhillon
authors: Siddhant
authors: S
authors: Yadav
authors: W Scott
authors: WS
authors: Harmsen
authors: Alan R
authors: AR
authors: Zinsmeister
authors: William J
authors: WJ
authors: Tremaine
authors: William J
authors: WJ
authors: Sandborn
authors: Edward V
authors: EV
authors: Loftus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003082:Colectomy / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D055815:Young Adult
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