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P634. Comparison of mortality following hospitalisation for ulcerative colitis in Scotland between 1998–2000 and 2007–2009

Background

We have previously demonstrated concerningly high 3-year mortality following hospitalisation with ulcerative colitis (UC) between 1998 and 2000 in Scotland [1]. We have extended these studies by examining 3-year mortality following hospitalisation with UC in Scotland between 2007–2009, providing an opportunity for comparison with our earlier results.

Aim: To compare 3-year mortality, and factors related to mortality, in Scottish patients hospitalised with ulcerative colitis (UC) between Period 1 (1998–2000) and Period 2 (2007–2009).

Methods

The Scottish Morbidity Records and linked datasets were used to assess 3-year crude 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

The admission rate with UC increased from 10.6 per 100,000 of the Scottish population per year in Period 1 to 11.6 in Period 2 (p = 0.046). The proportion undergoing colectomy was unchanged (p = 0.7). Among those admitted with UC, the proportion aged <30 yrs increased (p = 0.009). Crude and adjusted 3-year mortality fell between time periods (Crude 12.2% [Period 1] to 8.3% [Period 2], adjusted OR 0.59, CI 0.42 to 0.81, p = 0.04). Following emergency medical admission, 3-year mortality was reduced in Period 2 (OR 0.58, p = 0.003). Within the >65 yrs age group crude 3-year mortality fell (38.8% to 28.7%, p = 0.02). The overall SMR was 3.04 in Period 1 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, older age and co-morbid remained associated with 3-year mortality in Period 2.

Conclusion

Although the mortality associated with admission remains high at 3 years, crude and adjusted rates suggest significant reductions over the last decade.

1. Nicholls, R J, (2010), Nationwide linkage analysis in Scotland implicates age as the critical overall determinant of mortality in ulcerative colitis., Alimentary pharmacology & therapeutics, 1310–21.

  • Written by:

    N. Ventham1, N. Kennedy1, A. Duffy2, D. Clark2, A. Crowe3, A. Knight3, J. Nicholls4, J. Satsangi1, 1NHS Lothian, Gastroenterology, Edinburgh, United Kingdom, 2NHS National Services, Information Services Division, Edinburgh, United Kingdom, 3Corvus Communications Ltd, Buxted, United Kingdom, 4Imperial College, St Mary's Campus, London, United Kingdom