title: Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re-Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012).
abstract: OBJECTIVE
  Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012.
  
  
  METHODS
  Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed.
  
  
  RESULTS
  Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis.
  
  
  CONCLUSIONS
  Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest;Hungary.
authors.forename: Petra A
authors.initials: PA
authors.lastname: Golovics
authors.affiliation: Department of Medicine, Csolnoky F. Province Hospital, Veszprem; Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Lakatos
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest;Hungary.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mandel
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest;Hungary.
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Lovasz
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest;Department of Medicine, Csolnoky F. Province Hospital, Veszprem; Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Vegh
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest;Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Kurti
authors.affiliation: Department of Medicine, Csolnoky F. Province Hospital, Veszprem; Hungary.
authors.forename: Istvan
authors.initials: I
authors.lastname: Szita
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest;Hungary.
authors.forename: Lajos S
authors.initials: LS
authors.lastname: Kiss
authors.affiliation: Department of Medicine, Grof Eszterhazy Hospital, Papa, Hungary.
authors.forename: Mihaly
authors.initials: M
authors.lastname: Balogh
authors.affiliation: Department of Medicine, Csolnoky F. Province Hospital, Veszprem; Hungary.
authors.forename: Tunde
authors.initials: T
authors.lastname: Pandur
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest, Hungary. lakatos.peter_laszlo@med.semmelweis-univ.hu.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Lakatos
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents