The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Comparing the clinical outcomes of young-onset and adult-onset ulcerative colitis: a multi-center Korean Association for the Study for Intestinal Diseases study

  • Kim, Ji Yeon (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Dong Il (Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Han, Dong Soo (Department of Internal Medicine, Hanyang University Guri Hospital) ;
  • Huh, Kyu-Chan (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Lee, Chang Kyun (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Shin, Jeong Eun (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Kim, Jae Hak (Department of Internal Medicine, Dongguk University College of Medicine) ;
  • Kim, You Sun (Department of Internal Medicine, Inje University College of Medicine) ;
  • Jung, Yunho (Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Jung, Sung-Ae (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Song, Hyun Joo (Department of Internal Medicine, Jeju National University College of Medicine) ;
  • Jang, Hyun Joo (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Young-Ho (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hong, Sung No (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2014.08.31
  • Accepted : 2015.09.01
  • Published : 2017.01.01
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Abstract

Background/Aims: The aim of this study was to compare the clinical features and outcomes of ulcerative colitis (UC) according to the age of onset in Korea. Methods: A total of 1,141 patients who were diagnosed with UC between July 1987 and November 2013 at 11 tertiary hospitals were enrolled. The baseline disease characteristic and disease state at onset, treatment during the disease course were retrospectively reviewed among patients with young-onset (YO, < 20 years) and adult-onset (AO, ${\geq}20years$). Severe outcome was defined as use of intravenous (IV) steroids, infliximab, immunosuppressant, or UC-related operation. Results: There were 55 YO patients (mean age, $17.8{\pm}2.4$) and 1,086 AO patients (mean age, $43.0{\pm}13.6$). High Mayo scores ($7.7{\pm}3.0$ vs. $5.6{\pm}2.7$, p = 0.000), extensive UC (52.7% vs. 25.8%, p = 0.000) and IV steroid (41.8% vs. 18.0%, p = 0.000), immunosuppressant (47.3% vs. 26.9%, p = 0.002), and infliximab (20.0% vs. 7.2%, p = 0.001) use were more frequent in the YO than in the AO group. According to multivariate analysis, severe outcomes were related to YO disease (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.27 to 3.71), body mass index < $23kg/m^2$ (HR, 1.46; 95% CI, 1.07 to 2.00), severe (HR, 2.29; 95% CI, 1.36 to 3.38), and moderate (HR, 2.48; 95% CI, 1.67 to 3.67) disease, extensive UC (HR, 2.90; 95% CI, 1.79 to 4.69), UC-related admission (HR, 63.89; 95% CI, 20.41 to 200.02), and oral steroid use (HR, 0.51; 95% CI, 0.39 to 0.67). Conclusions: UC with YO presented with more advanced clinical features at onset and more severe outcomes than the AO. YO cases require careful management and intense treatment strategies.

Keywords

Acknowledgement

Supported by : Ministry of Health and Welfare

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