title: Clinical course and predictors of total colectomy in ulcerative colitis; a referral center experience from Turkey.
abstract: OBJECTIVE
  We aimed to describe the clinical course of Ulcerative colitis (UC) and the factors that predict the need for total colectomy in Turkish patients with severe UC receiving regular follow up.
  
  
  METHODS
  We analyzed the demographic and clinical characteristics of 612 patients with UC receiving regular follow up between 1994 and 2010 in a tertiary referral center in Ankara.
  
  
  RESULTS
  Men accounted for 58% of patients (M:F ratio, 1.4:1), and the mean age at diagnosis was 37.9 years. Of these, 32% had distal colitis and 8.8% had further extension, and 39 patients (6.4%) had chronic active disease. Steroid dependency and steroid resistance rates were 7.5% and 17.2%, respectively. In multivariate analysis, steroid dependency (p=0.04), steroid resistance (p=0.002), further extension (p<0.001), presence of extensive disease (p=0.006), and chronic active disease (p<0.001) were independent predictors of the need for total colectomy. Patients with chronic active disease had lower total colectomy free survival (p<0.001).
  
  
  CONCLUSIONS
  The predictors of total colectomy were comparable with those previously reported in the literature. However, we identified further extension in disease localization to predict the need for total colectomy.
authors.affiliation: Department of Gastroenterology, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey. drismailster@gmail.com.
authors.forename: İsmail Hakkı
authors.initials: İH
authors.lastname: Kalkan
authors.forename: Ülkü
authors.initials: Ü
authors.lastname: Dağlı
authors.forename: Murat
authors.initials: M
authors.lastname: Kekilli
authors.forename: Erkin
authors.initials: E
authors.lastname: Öztaş
authors.forename: Bilge
authors.initials: B
authors.lastname: Tunç
authors.forename: Aysel
authors.initials: A
authors.lastname: Ülker
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003082:Colectomy / Q000706:statistics & numerical data*; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013256:Steroids / Q000627:therapeutic use; D062606:Tertiary Care Centers; D014421:Turkey; D055815:Young Adult
chemical_list: D013256:Steroids