P684 Patient clinical characteristics at diagnosis of Ulcerative Colitis
I. Marin-Jimenez*1, C. Saro2, V. Díaz3, A. Gutierrez4, N. Borruel5, M. Gómez-García6, M. Barreiro-de Acosta7
1Hospital General Universitario Gregorio Marañón, Digestive Medicine- Gastroenterology section, Madrid, Spain, 2Hospital de Cabueñes, Digestive Department, Gijon, Spain, 3AbbVie Farmacéutica S.L.U., Inmunology, Madrid, Spain, 4Hospital General Universitario, Digestive Medicine Department, Alicante, Spain, 5Hospital Universitario Vall d´Hebrón, Gastroenterology, Barcelona, Spain, 6Hospital Universitario Virgen de las Nieves, Digestive Department, Granada, Spain, 7Hospital Clínico Universitario, Gastroenterology- Inflammatory Bowel Disease Unit, Santiago de Compostela, Spain
A nationwide study on the clinical features and course of ulcerative colitis (UC) in Spain is lacking. We aim to describe the socio-demographic and clinical characteristics of the UC disease present at diagnosis in the patients attending a gastroenterology unit in Spain.
A retrospective, multicenter, cross-sectional study was conducted (EPICURE study). At 58 selected gastroenterology units, adult patients with confirmed UC at any stage or extent of disease were randomly invited to participate. Data concerning the UC at diagnosis were collected during a single routine follow-up visit. Descriptive univariate analyses of data were performed.
A total of 568 UC patients were recruited. A 55% of patients were male. Median age at diagnosis was 36 years [Q1, Q3: 28, 47]; Median age for female patients (33 years; [Q1, Q3: 25, 44]) was lower than for males (40 years [Q1, Q3: 30, 50]) (p<0.0001). Before being diagnosed with UC patients had been presenting symptoms for a median of 3 months [Q1, Q3: 1, 6].
Data on extension of UC at diagnosis was available in 93.9% of patients being left sided colitis the most common (38.2%; n=217) followed by extensive UC (32.4%; n=184) and proctitis (23.1%; n=131). Median values for Mayo Total and Partial scores were 7.0 [Q1, Q3: 6.0, 9.0] and 6.0 [Q1, Q3: 4.5, 9.0], respectively. Type of UC extent of disease at diagnosis was significantly associated with severity of disease as per Mayo Total (6 for proctitis [n=85], 7 for left sided [n=160] and 8 for extensive UC [n=141]; p<0.0001) and Partial (5 for proctitis [n=24], 6 for left sided [n=20] and 6 for extensive UC [n=15]; p=0.0277) median scores. According to the Mayo score, 30.8% (n=175), 54.9% (n=312) and 12.7% (n=72) of patients presented mild, moderate or severe UC disease, respectively. Regarding smoking habits, 288 (50.7%), 129 (22.7%) and 149 (26.2%) patients were never, current and former smokers, respectively.
The most frequent diagnostic imaging procedures were colonoscopy or rectosigmoidoscopy in 448 (78.9%) and 134 (23.6%) patients, respectively, and endoscopy in 293 (51.6%) patients. MRI was done in 1.4% of patients. Histological exam was available in 499 (87.8%) patients with findings suggestive of UC in 88.8% (n=443). Tuberculosis screening was performed at diagnosis by Chest X-ray in 130 (22.9%), Mantoux test in 67 (11.8%) and Booster test in 33 (5.8%) patients.
Overall, clinical characteristics at diagnosis of UC patients in our cohort are consistent with most studies in Europe. A male preponderance was seen. Most patients were former/never smokers at diagnosis. The extent of disease was significantly associated with Mayo disease severity at diagnosis.