S1142 The Pattern and Outcome of Acute Severe Colitis

Abstract

Background: The prognosis of acute severe ulcerative colitis (ASC) influences therapeutic decisions, but data on prevalence or long-term outcome are few. Methods: To assess the prevalence of ASC defined by Truelove and Witts' (TW) criteria and determine whether outcome is related to disease activity on admission, the likelihood of recurrence and longterm prognosis, a systematic review of all patients with UC diagnosed in Oxford was performed. Results: 750 patients with UC (median follow up 12.7yr, range 0-648mo) were evaluated out of a total cohort of 1853 patients. 24.8% (186/750) had at least one admission for ASC (294 admissions in 186 patients). Overall, 12% (93/750) had a colectomy, compared to 39.8% (74/186) of patients with one or more episodes of ASC (p 6 bloody bowel motions/ day, compared to 31% (29/94) if two additional criteria were present and 48% (29/60) if three additional criteria were present (p=1.2x10-6; OR 4.01, 95% CI 2.24-7.19 one criterion vs two or more). Conclusions: A quarter of all patients with ulcerative colitis experience at least one episode of ASC; 20% come to colectomy on the first admission, but 40% after two admissions. The likelihood of colectomy is related to biological severity on admission.