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Comparing the clinical outcomes of young-onset and adult-onset ulcerative colitis: a multi-center Korean Association for the Study for Intestinal Diseases study

Title
Comparing the clinical outcomes of young-onset and adult-onset ulcerative colitis: a multi-center Korean Association for the Study for Intestinal Diseases study
Authors
Kim, Ji YeonPark, Dong IlHan, Dong SooHuh, Kyu-ChanLee, Chang KyunShin, Jeong EunKim, Jae HakKim, You SunJung, YunhoJung, Sung-AeSong, Hyun JooJang, Hyun JooKim, Young-HoHong, Sung No
Ewha Authors
정성애
SCOPUS Author ID
정성애scopus
Issue Date
2017
Journal Title
KOREAN JOURNAL OF INTERNAL MEDICINE
ISSN
1226-3303JCR Link2005-6648JCR Link
Citation
vol. 32, no. 1, pp. 69 - +
Keywords
Colitis, ulcerativeYoung-onsetClinical featureOutcome
Publisher
KOREAN ASSOC INTERNAL MEDICINE
Indexed
SCIE; SCOPUS; KCI WOS scopus
Abstract
Background/Aims: The aim of this study was to compare the clinical features and outcomes of ulcerative colitis (UC) according to the age of onset in Korea. Methods: A total of 1,141 patients who were diagnosed with UC between July 1987 and November 2013 at 11 tertiary hospitals were enrolled. The baseline disease characteristic and disease state at onset, treatment during the disease course were retrospectively reviewed among patients with young-onset (YO, < 20 years) and adult-onset (AO, >= 20 years). Severe outcome was defined as use of intravenous (IV) steroids, infliximab, immunosuppressant, or UC-related operation. Results: There were 55 YO patients (mean age, 17.8 +/- 2.4) and 1,086 AO patients (mean age, 43.0 +/- 13.6). High Mayo scores (7.7 +/- 3.0 vs. 5.6 +/- 2.7, p = 0.000), extensive UC (52.7% vs. 25.8%, p = 0.000) and IV steroid (41.8% vs. 18.0%, p = 0.000), immunosuppressant (47.3% vs. 26.9%, p = 0.002), and infliximab (20.0% vs. 7.2%, p = 0.001) use were more frequent in the YO than in the AO group. According to multivariate analysis, severe outcomes were related to YO disease (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.27 to 3.71), body mass index < 23 kg/m(2) (HR, 1.46; 95% CI, 1.07 to 2.00), severe (HR, 2.29; 95% CI, 1.36 to 3.38), and moderate (HR, 2.48; 95% CI, 1.67 to 3.67) disease, extensive UC (HR, 2.90; 95% CI, 1.79 to 4.69), UC-related admission (HR, 63.89; 95% CI, 20.41 to 200.02), and oral steroid use (HR, 0.51; 95% CI, 0.39 to 0.67). Conclusions: UC with YO presented with more advanced clinical features at onset and more severe outcomes than the AO. YO cases require careful management and intense treatment strategies.
DOI
10.3904/kjim.2014.262
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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