P688 Demographic, clinical, and therapeutic characteristics of a cohort of 238 patients with ulcerative colitis from two medical centres from Uruguay

Abstract

Background: Cohort follow-up studies allow to study clinical and therapeutic characteristics of patients with ulcerative colitis (UC). The results of these studies allow to plan sanitary strategies. The objective was to describe the demographic, clinical, and therapeutic characteristics of a cohort of patients with UC from two healthcare centres in Uruguay. Method(s): A descriptive, retrospective, and prospective study of patients with a diagnosis of UC coming from a public centre, Hospital de Clinicas (HC) and a private centre, CASMU, included in the National Registry of inflammatory bowel disease (RNEII) up to December 31, 2015 and followed until April 6, 2017. The RNEII includes demographic data, clinical characteristics, and medical and surgical treatment. The RNEII was approved by the ethics committee of the Faculty of Medicine. Result(s): A total of 238 patients were analysed, 94 from the HC and 139 from the CASMU. The median follow-up was 10.2 years (minimum 1-maximum 62.7 years). Women were 69.3% and men 30.7% (female/male ratio of 2.27, p <0.01). The mean age at diagnosis was 35.2 years (minimum 1-maximum 87 years), with a diagnosis peak between 20 and 29 years. 60.1% are non-smokers, 23.5% are former smokers. 31.1% had extraintestinal manifestations, arthropathy (14.3%), and primary sclerosing cholangitis (6.7%). The delay in diagnosis was greater than 12 months in 35.2% of patients. The location at diagnosis was: left-sided in 36.5%, extensive in 31.5% and proctitis in 18.9%. A proximal extension was observed in the evolution in 17.4%. To induce remission, 86.2% received aminosalicylates, 53.4% corticosteroids, 4.6% immunosuppressants and 1.4% Anti TNF. For maintenance of remission, 94.8% received aminosalicylates, 19.4% corticosteroids, 17.8% immunosuppressants and 1% Anti TNF. Twenty-five patients needed surgery (10.5%), 12 patients underwent proctocolectomy, 9 with Pouch and 3 with definitive ileostomy, 10 patients underwent colectomy, and 3 segmental colectomy. Surgery was required due to severe active UC in 52% and in 28% for continuous chronic UC, 8% for dysplasia, 8% for colorectal cancer. 4 patients (1.7%) developed colorectal cancer. 18 patients died (7.6%). Conclusion(s): The clinical characteristics of UC are similar to that reported in Latin America. The proximal extension of UC occurs in 17% of cases, which affirms the need for an endoscopic re-evaluation in evolution. There is a delay in diagnosis in a large proportion of patients. The use of corticosteroids in the maintenance phase is high and that of immunosuppressors and Anti TNF is low. In spite of this, the surgery rate is the expected one, but the type of surgery mostly used is not the one indicated as gold standard.