Leeds IA, et al. - In this cohort study of patients undergoing emergent total abdominal colectomies for ulcerative colitis, outcomes of early vs delayed emergency colectomy were compared while controlling for known preoperative risks and acuity. From the American College of Surgeons National Surgical Quality Improvement Program database, 573 adult patients with total abdominal colectomies were identified. Findings revealed decreased postoperative complications and mortality rates among patients who underwent immediate surgical intervention for acute ulcerative colitis. Patients expected to require surgery on the same admission may benefit from rapid and early transitioning from medical to surgical management.