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Short-term colectomy is avoided in over half of regional patients failing medical therapy for acute severe ulcerative colitis with co-ordinated transfer and tertiary care
- Source :
- Internal medicine journalReferences. 50(7)
- Publication Year :
- 2019
-
Abstract
- Background: Many patients presenting with an acute severe ulcerative colitis to a regional hospital are transferred to a metropolitan hospital for specialised care.Aims: To evaluate the outcomes and characteristics of these patients.Method: A retrospective observational cohort study was conducted to examine the 30-day colectomy rate using prospectively collected data on 69 consecutive index cases of acute severe ulcerative colitis transferred from regional hospitals to our metropolitan hospital meeting Truelove and Witts criteria. Those that avoided colectomy were followed out to 1 year to examine outcomes.Results: The 30-day colectomy rate was 46.4% (32/69) in regional transfer patients. Rescue therapy was administered to 65% (45/69) of patients after transfer to our metropolitan hospital. Colectomy was avoided in 55% of these patients at 30 days. Colectomy free status was maintained in 78%(29/39) of these patients. Mortality was 0% at 30 days and 1 year.Conclusion: Over 50% of the patients failing therapy in a regional centre and requiring transfer avoided short term colectomy with co-ordinated referral for rescue therapy in a tertiary metropolitan inflammatory bowel disease unit. These patients would have ultimately required colectomy in their regional hospital without intervention.
- Subjects :
- medicine.medical_specialty
Referral
medicine.medical_treatment
030204 cardiovascular system & hematology
Tertiary care
Inflammatory bowel disease
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
Rescue therapy
Internal Medicine
medicine
Humans
030212 general & internal medicine
Colectomy
Retrospective Studies
business.industry
Tertiary Healthcare
General surgery
medicine.disease
Ulcerative colitis
Treatment Outcome
Colitis, Ulcerative
business
Medical therapy
Cohort study
Subjects
Details
- ISSN :
- 14455994
- Volume :
- 50
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Internal medicine journalReferences
- Accession number :
- edsair.doi.dedup.....2371a0d88cd5f88bf3f42054407d1cc9