Introduction We have previously demonstrated concerningly high 3-year mortality following hospitalisation with ulcerative colitis (UC) between 1998 and 2000 in Scotland.1 We have extended these studies by examining 3-year mortality following hospitalisation with UC in Scotland between 2007–2009, providing an opportunity for comparison with our earlier results.
Aim To compare 3-year mortality, and factors related to mortality, in Scottish patients hospitalised with ulcerative colitis (UC) between Period 1 (1998–2000) and Period 2 (2007–2009).
Methods The Scottish Morbidity Records and linked datasets were used to assess 3-year crude mortality, standardised mortality ratio (SMR) and multivariate analyses of factors associated with 3-year mortality. The 3-year mortality was determined after four admission types: surgery-elective or emergency; medical-elective or emergency. Age-standardised mortality rates (ASR) were used to compare mortality rates between periods.
Results The admission rate with UC increased from 10.6 per 100,000 of the Scottish population per year in Period 1 to 11.6 in Period 2 (p = 0.046). Among those admitted with UC, the proportion aged <30yrs increased (p = 0.009). Crude and adjusted 3-year mortality fell between time periods (Crude 12.2% [Period 1] to 8.3% [Period 2], adjusted OR 0.59, CI 0.42 to 0.81, p = 0.04). Following emergency medical admission, 3-year mortality was reduced in Period 2 (OR 0.58, p = 0.003). Within the >65 yrs age group crude 3-year mortality fell (38.8% to 28.7%, p = 0.02). The overall SMR in period 1 was 3.04 and 2.96 in Period 2.
Directly age standardised mortality decreased from 373 (CI 309–437) to 264 (CI 212–316) per 10,000 person years. On multivariate analysis, older age and co-morbid remained associated with 3-year mortality in Period 2.
Conclusion Although the mortality associated with admission remains high at 3 years, crude and adjusted rates suggest significant reductions over the last decade.
Nicholls RJ, Clark DN, Kelso L, et al. Nationwide linkage analysis in Scotland implicates age as the critical overall determinant of mortality in ulcerative colitis. Aliment Pharmacol Ther 2010;31:1310–21
Disclosure of Interest N. Ventham: None Declared, N. Kennedy: None Declared, A. Duffy: None Declared, D. Clark: None Declared, A. Crowe: None Declared, A. Knight: None Declared, J. Nicholls Grant/research support from: A grant was obtained from AbbVie Ltd to be administered by the North West London Hospital Trust (NWLHT) on behalf of Prof Nicholls, to allow funding of ISD and Corvus Communications for their work on the project. In the context of the work presented in this manuscript and in consideration of BMJ guidance, none of the authors have any competing or other conflict of interest, J. Satsangi: None Declared.