Department of Pharmaceutical Biosciences, Translational Drug Discovery and Development, Uppsala University, Uppsala, Sweden.
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Ups J Med Sci. 2022 Oct 18;127. doi: 10.48101/ujms.v127.8833. eCollection 2022.
Ulcerative colitis (UC) is a debilitating inflammatory bowel disease. Present knowledge regarding UC disease progression over time is limited.
To assess UC progression to severe disease along with disease burden and associated factors.
Electronic medical records linked with Swedish national health registries (2005-2015) were used to identify disease progression of UC. Odds of all-cause and disease-related hospitalization within 1 year were compared between patients with disease progression and those without. Annual indirect costs were calculated based on sick leave, and factors related to UC progression were examined.
Of the 1,361 patients with moderate UC, 24% progressed to severe disease during a median of 5.2 years. Severe UC had significantly higher odds for all-cause (OR [odds ratio] 1.47, 95% CI [confidence interval]: 1.12-1.94, < 0.01) and UC-related hospitalization (OR 2.47, 95% CI: 1.76-3.47, < 0.0001) compared to moderate disease. Average sick leave was higher in patients who progressed compared to those who did not (64.4 vs 38.6 days, < 0.001), with higher indirect costs of 151,800 SEK (16,415 €) compared with 92,839 SEK (10,039 €) ( < 0.001), respectively. UC progression was related to young age (OR 1.62, 95% CI: 1.17-2.25, < 0.01), long disease duration (OR 1.09, 95% CI: 1.03-1.15, < 0.001), and use of corticosteroids (OR 2.49, 95% CI: 1.67-3.72, < 0.001).
Disease progression from moderate to severe UC is associated with more frequent and longer hospitalizations and sick leave. Patients at young age with long disease duration and more frequent glucocorticosteroid medication are associated with progression to severe UC.
溃疡性结肠炎（UC）是一种使人虚弱的炎症性肠病。目前对 UC 随时间推移的疾病进展的了解有限。
评估 UC 向严重疾病的进展情况以及疾病负担和相关因素。
使用电子病历与瑞典国家健康登记处（2005-2015 年）相关联，以确定 UC 的疾病进展情况。比较有和无疾病进展的患者在一年内全因和与疾病相关的住院的几率。根据病假计算每年的间接费用，并检查与 UC 进展相关的因素。
在 1361 名中度 UC 患者中，24%在中位数为 5.2 年的时间内进展为严重疾病。严重 UC 患者全因（OR [比值比] 1.47，95%CI [置信区间]：1.12-1.94，<0.01）和 UC 相关住院（OR 2.47，95%CI：1.76-3.47，<0.0001）的几率明显更高。与未进展的患者相比，进展的患者的病假时间更长（64.4 天 vs 38.6 天，<0.001），间接费用更高（分别为 151,800 瑞典克朗（16,415 欧元）和 92,839 瑞典克朗（10,039 欧元），<0.001）。UC 进展与年龄较小（OR 1.62，95%CI：1.17-2.25，<0.01）、疾病持续时间较长（OR 1.09，95%CI：1.03-1.15，<0.001）和皮质类固醇的使用（OR 2.49，95%CI：1.67-3.72，<0.001）有关。
从中度 UC 向严重 UC 的疾病进展与更频繁和更长时间的住院和病假有关。年轻、疾病持续时间长、皮质类固醇药物使用更频繁的患者更易进展为严重 UC。
