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Proximal disease extension and related predicting factors in ulcerative proctitis

Authors
 Bun Kim  ;  Soo Jung Park  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Won Ho Kim  ;  Jae Hee Cheon 
Citation
 SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, Vol.49(2) : 177-183, 2014 
Journal Title
 SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY 
ISSN
 0036-5521 
Issue Date
2014
MeSH
Adult ; Colitis, Ulcerative/pathology* ; Colon ; Disease Progression ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Male ; Middle Aged ; Proctocolitis/pathology* ; Recurrence ; Retrospective Studies ; Risk Factors ; Severity of Illness Index* ; Sigmoidoscopy ; Young Adult
Keywords
disease extension ; proctitis ; progression ; ulcerative colitis
Abstract
OBJECTIVE: Ulcerative colitis usually involves the rectum, may extend in a proximal and continuous fashion to involve varying portions of the bowel. However, the risk factors predictive of proximal extension have yet to be determined. The aim of this study was to evaluate both the natural course of disease and the risk factors influencing the proximal disease extension in ulcerative proctitis. MATERIAL AND METHODS: We retrospectively analyzed 98 patients with ulcerative proctitis at the time of diagnosis who were regularly followed and underwent sigmoidoscopy or colonoscopy between January 2000 and December 2007. RESULTS: The mean duration of follow-up was 109.2 ± 49.5 months. A total of 27 (27.6%) patients experienced proximal disease extension. Mayo scores were significantly higher in the extension group compared with patients whose ulcerative proctitis did not extend proximally (p < 0.001). Corticosteroid use at initial diagnosis was also more frequent in the extension group (p = 0.026). In addition, chronic, continuous disease activation within 6 months of the initial diagnosis was significantly higher in the extension group (p < 0.001), as was disease relapse and the number of hospitalizations over the entire follow-up period (p < 0.001 and p = 0.002). According to multivariate analysis, disease extension after the initial diagnosis was associated with chronic disease activation, disease relapse and hospitalization (p = 0.030, p = 0.042 and p = 0.044, respectively). CONCLUSION: Increased severity of disease upon diagnosis of ulcerative proctitis was associated with a higher probability of proximal disease extension during the follow-up period. Moreover, those with disease extension were more likely to experience relapse and to be hospitalized, indicating poor prognosis.
Full Text
http://informahealthcare.com/doi/abs/10.3109/00365521.2013.867360
DOI
10.3109/00365521.2013.867360
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Bun(김번)
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Park, Soo Jung(박수정)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98007
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