Cytomegalovirus reactivation and steroid refractory are the independent risk factors for colonic surgery in ulcerative colitis

Abstract

To explore the risk factors of surgery in patients with ulcerative colitis (UC). Patients with UC, hospitalized from January 2005 to October 2012 were retrospectively enrolled in this study. Univariate and multivariate analyses were used to reveal the risk factors of colon surgery, including demographic features, clinical manifestations, laboratory examinations and medication. A total of 273 UC patients were enrolled in this study with 39 (14.3%) patients receiving colon surgery. Compared with the flare group, patients in surgery group 71.8% (28/39) had more proportion with severe disease (P=0.008), higher prevalence of active cytomegalovirus (CMV) infection [47.6% (10/21) vs 10.9% (11/101), P<0.001], higher ratio of steroid resistance [60.0% (15/25) vs 10.7% (18/168), P<0.001], more receiving cyclosporine A [28.2% (11/39) vs 7.3% (17/234), P<0.001], and lesser with 5-aminosalicylic acid [82.1% (32/39) vs 95.3% (223/234), P=0.007]. Based on multivariate logistic regression analyses, active CMV infection and steroid resistance were two independent risk factors of colon surgery in UC patients (P=0.006 and 0.030, OR=6.040 and 17.928). Active CMV infection and steroid resistance are independent risk factors of colon surgery in UC.