P634. Comparison of mortality following hospitalisation for ulcerative colitis in Scotland between 1998–2000 and 2007–2009
We have previously demonstrated concerningly high 3-year mortality following hospitalisation with ulcerative colitis (UC) between 1998 and 2000 in Scotland . 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).
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.
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.
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.