title: Clinical predictors of colectomy in patients with ulcerative colitis: systematic review and meta-analysis of cohort studies.
abstract: BACKGROUND
  Colectomy is a major event that may significantly affect the outcome of ulcerative colitis (UC) in terms of both quality of life and mortality. This paper aims to identify clinical prognostic factors that may be significantly associated with this event.
  
  
  METHODS
  PubMed, ISI Web of Knowledge and Scopus were searched to identify studies investigating the association between clinical factors in adult patients with UC and studied events.The clinical factors evaluated in this meta-analysis were gender, smoking habits, disease extent,use of corticosteroids, and episodes of hospitalization.
  
  
  RESULTS
  Of the 3753 initially selected papers, 20 were included. The analysis showed a significantly lower risk of colectomy for female patients (odds ratio [OR] 0.78 [95% CI 0.68, 0.90]) and for smoking patients (OR 0.55 [0.33, 0.91]), and a higher risk for patients with extensive disease (OR 3.68 [2.39,5.69]), for patients who took corticosteroids at least once (OR 2.10 [1.05, 4.22]), and for patients who were hospitalized (OR 4.13 [3.23, 5.27]).
  
  
  CONCLUSIONS
  Gender, smoking habits, disease extent, need for corticosteroids, and hospitalization were all significantly associated with UC prognosis. These results may clarify the relative influences of these and other prognostic factors in the natural course of the disease and therefore help improve the management approach, thus improving the follow-up of patients.
authors.forename: Cláudia Camila
authors.initials: CC
authors.lastname: Dias
authors.forename: Pedro Pereira
authors.initials: PP
authors.lastname: Rodrigues
authors.forename: Altamiro
authors.initials: A
authors.lastname: da Costa-Pereira
authors.forename: Fernando
authors.initials: F
authors.lastname: Magro
mesh_terms: D003082:Colectomy; D003093:Colitis, Ulcerative / Q000601:surgery*; D006801:Humans; D011379:Prognosis; D011788:Quality of Life