title: Comparison of mortality following hospitalisation for ulcerative colitis in Scotland between 1998-2000 and 2007-2009.
abstract: BACKGROUND
  Scottish nationwide linkage data from 1998 to 2000 demonstrated high 3-year mortality in patients hospitalised with ulcerative colitis (UC).
  
  
  OBJECTIVE
  To compare 3-year mortality, and factors related to mortality, in Scottish patients hospitalised with UC between 1998-2000 and 2007-2009.
  
  
  METHODS
  The Scottish Morbidity Records and linked datasets were used to assess 3-year mortality, standardised mortality ratio (SMR) and multivariate analyses of factors associated with 3-year mortality. The 3-year mortality was determined after four admission types: surgery-elective or emergency; medical-elective or emergency. Age-standardised mortality rates (ASR) were used to compare mortality rates between periods.
  
  
  RESULTS
  Ulcerative colitis admissions increased from 10.6 in Period 1 to 11.6 per 100 000 population per year in Period 2 (P = 0.046). Crude and adjusted 3-year mortality fell between time periods (crude 12.2% to 8.3%; adjusted OR 0.59, CI 0.42-0.81, P = 0.04). Adjusted 3-year mortality following emergency medical admission (OR 0.58, CI 0.39-0.87, P = 0.003) and in patients >65 years (38.8% to 28.7%, P = 0.02) was lower in Period 2. The SMR in period 1 was 3.04 and 2.96 in Period 2. Directly age-standardised mortality decreased from 373 (CI 309-437) to 264 (CI 212-316) per 10 000 person-years. On multivariate analysis, increasing age (50-64 years OR 7.11 (CI 2.77-18.27, P < 0.05); 65-74 years OR 14.70 (CI 5.65-38.25 P < 0.05); >75 years OR 46.42 (CI 18.29-117.78, P < 0.001) and co-morbidity (OR 3.02, CI 1.72-5.28, P < 0.001) were significantly associated with 3-year mortality in Period 2.
  
  
  CONCLUSIONS
  Comparisons of crude and adjusted mortality rates suggest significant improvement in outcome over the last decade - however, mortality remains high, and older age and co-morbidity are important predictors of outcome.
authors.affiliation: GI Unit, Centre for Genomics and Molecular Medicine, Western General Hospital, Edinburgh, UK.
authors.forename: N T
authors.initials: NT
authors.lastname: Ventham
authors.forename: N A
authors.initials: NA
authors.lastname: Kennedy
authors.forename: A
authors.initials: A
authors.lastname: Duffy
authors.forename: D N
authors.initials: DN
authors.lastname: Clark
authors.forename: A M
authors.initials: AM
authors.lastname: Crowe
authors.forename: A D
authors.initials: AD
authors.lastname: Knight
authors.forename: R J
authors.initials: RJ
authors.lastname: Nicholls
authors.forename: J
authors.initials: J
authors.lastname: Satsangi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003093:Colitis, Ulcerative / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012606:Scotland / Q000453:epidemiology