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DOP047. Is hospitalization predicting the disease course in UC? Prevalence and predictors of hospitalization and re-hospitalization in ulcerative colitis in a population-based inception cohort between 2000–2012

B. Lovasz1, M. Mandel1, P.A. Golovics1, I. Szita2, Z. Vegh1, L. Kiss1, A. Horvath3, T. Pandur2, M. Balogh4, A. Mohas1, B. Szilagyi1, L. Lakatos2, P. Lakatos1, 1Semmelweis University, 1st Department of Medicine, Budapest, Hungary, 2Csolnoky F. Province Hospital, Department of Medicine, Veszprem, Hungary, 3Csolnoky F. Province Hospital, Department of Pediatrics, Veszprem, Hungary, 4Grof Eszterhazy Hospital, Department of Medicine, Papa, Hungary

Background

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 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, duration: 7, IQR 4–10 years). Both in- and outpatient records were collected and comprehensively reviewed.

Results

Probabilities of first UC-related hospitalization and first re-hospitalization were 28.6%, 53.7%, 66.2% and 23.7%, 55.8% and 74.6% after 1, 5 and 10 years of follow-up in Kaplan–Meier analysis. Main reasons for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC related surgery (4.8%), but the majority of the hospitalizations were unrelated to UC (44.8%). In Kaplan–Meier and Cox-regression analysis disease extent at diagnosis (HR: 1.35, p = 0.018, HRextensive: 1.79, p = 0.02 vs. proctitis) 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, however 46.2% of all colectomies were performed in the year of diagnosis.

Conclusion

Hospitalization and re-hospitalization rates are relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.