P0796 Comparison of Disease Severity, Treatment, and Outcomes in Elderly and Younger Patients Hospitalized with Acute Severe Ulcerative Colitis (ASUC)
J Ollech, R Lev Kolnik, I Dotan, H YanaiAbstract
Background
Acute severe ulcerative colitis (ASUC) is a life-threatening complication that requires prompt and effective treatment. Disease severity, treatment approaches, and outcomes may differ between elderly patients (aged ≥60 years) and younger patients. This study aims to compare these factors in a cohort of hospitalized ASUC patients.
Methods
A retrospective cohort study was conducted including all patients admitted between 1/2018-12/2023, with ASUC who failed oral steroid therapy to Rabin Medical Center in Israel, a large tertiary referral center. Baseline disease severity was assessed using hemoglobin, albumin, and C-reactive protein (CRP). Treatments analyzed included the use of rescue therapies such as infliximab and calcineurin inhibitors for patients failing intravenous corticosteroid therapy. Outcomes such as colectomy and mortality associated with ASUC were recorded.
Results
158 patients met the inclusion criteria and were stratified into two groups: elderly patients (≥60 years, n=16) and younger patients (<60 years, n=142).Elderly patients had a mean age of 72.9 years compared to 32.1 years in younger patients. Baseline hemoglobin levels were similar between the two groups (11.7 g/dL in elderly vs. 11.8 g/dL in younger patients). Albumin levels were also similar in elderly patients (3.6 g/dL) compared to younger patients (3.8 g/dL) as were CRP levels (5.7 mg/dl vs 5.8 md/dl) respectively. The use of infliximab was less common in elderly patients (12.5%, n=2) compared to younger patients (24.6%, n=35). Calcineurin inhibitors (ciclosporin or tacrolimus) were used in only 1 elderly patient (6.25%) but were used in almost 15 % (n=19) of younger patients. No elderly patients underwent colectomy during admission, while 7.0% (n=10) of younger patients did. Mortality was higher in elderly patients, with a case fatality rate of 12.5% (n=2), compared to no reported mortality in younger patients.
Conclusion
Elderly patients hospitalized with ASUC had similar baseline disease severity but received less rescue therapies and had worse outcomes compared to younger patients, including a higher mortality rate. These findings suggest that while disease severity may be comparable across age groups, elderly patients may experience greater complications, underscoring the need for tailored treatment approaches in this population.