ASUC was defined using the Truelove and Witts criteria: that is frequency of six or more bloody stools per day together with any one of the following criteria:
* Patients admitted with a clinical diagnosis of ASUC satisfying Truelove and Witts criteria
* Patients who had undergone a colectomy, with a confirmed clinical and histological diagnosis of ASUC.
Data collected included baseline demographics (age, gender, family history, ethnicity, smoking status, duration of UC prior to ASUC diagnosis, time from diagnosis to presentation, and medication exposure on admission).
Ninety-eight (98) patients with ASUC were eligible for study inclusion.
The group of patients undergoing surgery for ASUC had a significantly shorter duration of disease than those in whom colectomy was avoided; 16 months and 41 months respectively (p=0.04).
None of the patients were on maintenance Infliximab at the time of ASUC admission, however 4 patients received Infliximab as rescue therapy and all of them avoided colectomy.
As a consequence, the role of prognostic factors in patients with ASUC has been the subject of much interest.
The widely used acute phase reactant CRP has established value in ASUC in both adults and children.
Deep ulceration on endoscopy is also an ominous sign in ASUC; 93% will require surgery.
Our study evaluated all of these aforementioned risk factors and has identified several which significantly predict colectomy during admission for ASUC. First, a shorter duration of disease conferred a higher risk of subsequent surgery than patients with a longer duration of disease.
Interestingly, most of the ASUC patients were female.