Mortality in ulcerative colitis—what should we tell our patients? Three year mortality following admission for the treatment of ulcerative colitis: a 6 year retrospective case review

Objectives To determine the 3 year mortality of patients admitted to hospital for the treatment of ulcerative colitis (UC). Design Retrospective case note review of all patients admitted to hospital for treatment of active UC over a 6 year period from 1 January 2000. Setting Teaching hospital with a tertiary referral practice for the management of infiammatory bowel disease. Patients 106 patients (134 admissions) met the inclusion criteria. Interventions Elective and emergency colectomy was undertaken in 16 and 26 patients, respectively. Main outcome measures Mortality at 3 years. Results There were six deaths after 3 years. Case fatality at 30 days, 1, 2 and 3 years was 1.0% (95% CI 0.2 to 5.1), 1.9% (95% CI 0.2 to 6.6), 2.9% (95% CI 5.9 to 8.0) and 5.7% (95% CI 2.1 to 11.9), respectively. There were no deaths in either surgical group. One patient (89 years, female) died while awaiting emergency colectomy. Patients who died were significantly older at the time of admission (79 years (95% CI 71 to 88 years) vs 41.2 years (95% CI 38 to 45 years)) and were more likely to have comorbid illness (p<0.001). Severity of disease, prior immunosuppressive use, first presentation and smoking status were not associated with increased mortality. Conclusions Three year mortality following admission for treatment of UC was 5.7% (95% CI 2.1 to 11.9), significantly lower than that reported previously. Mortality was significantly associated with increasing age and the presence of comorbid disease. Disease specific factors such as severity, extent and first presentation were associated with emergency colectomy but not mortality.