P-042 Clinical Characteristics and Long-term Outcomes of Elderly-Onset Ulcerative Colitis

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Abstract

Background:

With the aging of the population, the incidence of elderly-onset ulcerative colitis (EOUC) is expected to increase. The aim of this study was to investigate clinical characteristics and outcomes of patients with EOUC.

Methods:

We retrospectively analyzed 3062 Korean UC patients who were diagnosed between 1977 and 2016 and managed at Asan Medical Center, Seoul, Korea. Characteristics and outcomes of EOUC patients, defined as age ≥60 years at diagnosis of UC, were compared with those of nonelderly-onset UC (NEOUC) patients.

Results:

Out of 3062 patients, 226 EOUC patients (7.4%, median age at diagnosis 66.0 [IQR, 60.0–90.5], male 58.4%) were identified. The frequency of EOUC increased from 3.9% between 1977 and 1999 to 9.7% between 2008 and 2014 (P < 0.001). There were more ex-smokers in the EOUC group (P < 0.001). In the EOUC group, extensive colitis at diagnosis of UC and extensive colitis as maximum extent was less common than in the NEOUC group (13.7% versus 22.6%, P = 0.002, and 34.5% versus 42.5%, P = 0.024, respectively). During follow-up (median 93.5 mo [IQR, 12.1–449.0]), the proportions of patients who were ever treated with corticosteroids and anti-TNF agents were similar, but, the use of thiopurine was less frequent in EOUC group (17.8% versus 24.6%, P = 0.023). Cumulative probabilities of colectomy at 5, 10 and 20 years after UC diagnosis were 7.4%, 7.9% and 9.0%, respectively in the EOUC group, and 2.8%, 4.8% and 7.3%, respectively in NEOUC group (P < 0.001).

Conclusions:

The frequency of EOUC appears to be increasing in recent years. EOUC group is likely to show distinct features at diagnosis and during follow-up compared with NEOUC group. More attention and further studies are needed in this special group of patients.

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