Short term colectomy is avoided in over half of regional patients failing medical therapy for acute severe ulcerative colitis with coordinated transfer and tertiary care
Internal Medicine Journal Oct 13, 2019
Patrick D, Doecke JD, Irwin J, et al. - Through a retrospective, observational cohort study that used prospectively obtained data on 69 consecutive index cases of acute severe ulcerative colitis (ASUC) transferred from regional hospitals to the metropolitan hospital meeting Truelove and Witts criteria, experts assessed the outcomes and features of these individuals. In regional transfer individuals, the 30-day colectomy rate was 46.4% (32/69). Subsequent to the transfer to the metropolitan hospital, rescue therapy was given to 65% (45/69) of individuals. At 30 days, colectomy was circumvented in 55% of these patients. In 78% (29/39) of these patients, colectomy free status was sustained. At 30 days and 1 year, mortality was 0%. Hence, in a tertiary metropolitan IBD unit with a coordinated referral for rescue therapy, over 50% of the individuals failing therapy in a regional center and needing transfer withdrew from short term colectomy. Moreover, in their regional hospital, these individuals would have conclusively needed colectomy without intervention.
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