Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
BMC Gastroenterol. 2020 Nov 12;20(1):377. doi: 10.1186/s12876-020-01527-1.
We aimed to characterize the trends of prognosis in ulcerative colitis (UC) and Crohn's disease (CD) in a Chinese tertiary hospital.
A 30-year retrospective cohort analysis was conducted at Peking Union Medical College Hospital. Consecutive patients newly diagnosed with UC or CD from 1985 to 2014 were included. The primary outcome was in-hospital mortality. The secondary outcomes included surgery and length of stay in hospital. The Pearson correlation coefficient was applied to determine the relationship between time and prognosis. Multivariable logistic regression analysis was performed to determine the risk factors for in-hospital mortality and surgery.
In total, 1467 patients were included in this study (898 cases with UC and 569 cases with CD). Annual admissions for UC and CD have increased significantly over the last 30 years (UC, r = 0.918, P < 0.05; CD, r = 0.898, P < 0.05). Decreased in-hospital mortality was observed both in patients with UC and CD (UC, from 2.44 to 0.27%, r = - 0.827, P < 0.05; CD, from 12.50 to 0.00%, r = - 0.978, P < 0.05). A decreasing surgery rate was observed in patients with CD (r = - 0.847, P < 0.05), while an increasing surgery rate was observed in patients with UC (r = 0.956, P < 0.05). Shortened average lengths of hospital stay were observed in both UC and CD patients (UC, from 47.83 ± 34.35 to 23.58 ± 20.05 days, r = - 0.970, P < 0.05; CD, from 65.50 ± 50.57 to 26.41 ± 18.43 days, r = - 0.913, P < 0.05). Toxic megacolon and septic shock were independent risk factors for in-hospital mortality in patients with UC. Intestinal fistula and intestinal perforation were independent risk factors for in-hospital mortality in patients with CD.
In this cohort, the admissions of patients with UC and CD were increased, with significantly improved prognoses during the past 30 years.
我们旨在描述中国一家三级医院溃疡性结肠炎（UC）和克罗恩病（CD）患者的预后趋势。
本研究为北京协和医学院医院的一项 30 年回顾性队列分析。纳入 1985 年至 2014 年期间新诊断为 UC 或 CD 的连续患者。主要结局为住院死亡率。次要结局包括手术和住院时间。采用 Pearson 相关系数确定时间与预后之间的关系。采用多变量逻辑回归分析确定住院死亡率和手术的危险因素。
本研究共纳入 1467 例患者（UC 898 例，CD 569 例）。过去 30 年，UC 和 CD 的年住院人数均显著增加（UC，r=0.918，P<0.05；CD，r=0.898，P<0.05）。UC 和 CD 患者的住院死亡率均呈下降趋势（UC，从 2.44%降至 0.27%，r=-0.827，P<0.05；CD，从 12.50%降至 0.00%，r=-0.978，P<0.05）。CD 患者的手术率呈下降趋势（r=-0.847，P<0.05），UC 患者的手术率呈上升趋势（r=0.956，P<0.05）。UC 和 CD 患者的平均住院时间均缩短（UC，从 47.83±34.35 天缩短至 23.58±20.05 天，r=-0.970，P<0.05；CD，从 65.50±50.57 天缩短至 26.41±18.43 天，r=-0.913，P<0.05）。中毒性巨结肠和感染性休克是 UC 患者住院死亡率的独立危险因素。肠瘘和肠穿孔是 CD 患者住院死亡率的独立危险因素。
在本队列中，UC 和 CD 患者的入院人数增加，在过去 30 年中，预后明显改善。
