Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Department of Internal Medicine, Sakura Medical Center, Toho University, Chiba, Japan.
J Gastroenterol Hepatol. 2018 Nov;33(11):1839-1843. doi: 10.1111/jgh.14263. Epub 2018 May 16.
Studies on the characteristics of elderly-onset ulcerative colitis (EOUC) and non-elderly-onset ulcerative colitis (NEOUC) have reported conflicting findings. The aim of this study was to compare disease characteristics of EOUC and NEOUC by analyzing the database of the Japanese nationwide inflammatory bowel disease (IBD) registry.
We analyzed the age of disease onset, sex, disease severity, and disease extent in patients with ulcerative colitis that were newly diagnosed and registered within 1 year between 2004 and 2009 (n = 28 179). We also analyzed the medical treatment, rate of IBD-related surgery, and postoperative complications. We compared them between younger than 65 years old (NEOUC group) and 65 years old or older (EOUC group) patients.
A total of 25 401 (90.1%) and 2778 (9.9%) patients were included in the NEOUC and EOUC groups, respectively. In the EOUC group, disease activity was significantly higher, and extent of pathological changes in the colon more extended significantly. Laboratory findings showed that inflammatory markers were elevated significantly in the EOUC group. The proportion of those with IBD-related hospitalization was significantly higher in the EOUC group (54.2% vs 35.7%, P < 0.001). The proportion of patients who were treated with corticosteroids was significantly higher in the EOUC group (36.7% vs 30.8%, P < 0.001). Significantly more number of patients underwent IBD-related surgery in the EOUC group (0.68% vs 0.27%, P < 0.001).
Elderly patients show higher disease activity, with a higher proportion requiring IBD-related hospitalization and IBD-related surgery, according to the nationwide registry in Japan.
关于老年发病溃疡性结肠炎（EOUC）和非老年发病溃疡性结肠炎（NEOUC）的特征的研究结果存在矛盾。本研究旨在通过分析日本全国炎症性肠病（IBD）登记处的数据库来比较 EOUC 和 NEOUC 的疾病特征。
我们分析了 2004 年至 2009 年期间新诊断并在 1 年内登记的溃疡性结肠炎患者的发病年龄、性别、疾病严重程度和疾病范围（n=28179）。我们还分析了治疗方法、IBD 相关手术率和术后并发症。将这些结果与年龄小于 65 岁（NEOUC 组）和 65 岁或以上（EOUC 组）的患者进行比较。
NEOUC 组和 EOUC 组分别有 25401（90.1%）和 2778（9.9%）例患者。在 EOUC 组中，疾病活动度明显更高，结肠病变范围明显更广。实验室检查结果显示，EOUC 组的炎症标志物明显升高。EOUC 组 IBD 相关住院的比例明显更高（54.2% vs 35.7%，P<0.001）。EOUC 组接受皮质类固醇治疗的患者比例明显更高（36.7% vs 30.8%，P<0.001）。EOUC 组接受 IBD 相关手术的患者明显更多（0.68% vs 0.27%，P<0.001）。
根据日本全国登记处的数据，老年患者的疾病活动度更高，需要 IBD 相关住院和 IBD 相关手术的比例更高。
