ArticleAnnals of internal medicine2015
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
Article in Annals of internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Systematic Review and Meta-analysis: Phenotype and Clinical Outcomes of Older-onset Inflammatory Bowel Disease.Journal of Crohn's & colitis · 2016Pooled it
- Treatment-Free Outcomes Following Surgery for IBD: A Nationwide Cohort Study.Alimentary pharmacology & therapeutics · 2026Article
- Preoperative performance status was associated with postoperative fatal complications in elderly patients with refractory ulcerative colitis.World journal of gastrointestinal surgery · 2025Article
- Risk of malnutrition increases in the year prior to surgery among patients with inflammatory bowel disease.Therapeutic advances in gastroenterology · 2025Article
- Comment on: Risk of malnutrition increases in the year prior to surgery among patients with inflammatory bowel disease.Therapeutic advances in gastroenterology · 2025Article
- Frailty: An Underappreciated Risk Factor for IBD Complications.Current gastroenterology reports · 2024Review
- Natural course of ulcerative colitis in China: Differences from the West?United European gastroenterology journal · 2024Article
- Management Considerations for the Older Adult With Inflammatory Bowel Disease.Gastroenterology & hepatology · 2023Article
- Long-Term Surgical Outcomes and Pathological Analysis of Proctectomy Specimens after Subtotal Colectomy for Ulcerative Colitis: A Retrospective Cohort Study from a Tertiary Centre.Journal of clinical medicine · 2023Article
- Review
- Ulcerative Colitis in Adulthood and in Older Patients: Same Disease, Same Outcome, Same Risks?Drugs & aging · 2022Review
- Optimal Placement of Colectomy in the Treatment of Ulcerative Colitis: a Markov Model Analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- A Practical Clinical Approach to the Management of High-Risk Ulcerative Colitis.Gastroenterology & hepatology · 2021Article
- The elderly IBD patient in the modern era: changing paradigms in risk stratification and therapeutic management.Therapeutic advances in gastroenterology · 2021Review
- Correlation between fecal calprotectin, ulcerative colitis endoscopic index of severity and clinical outcome in patients with acute severe colitis.Experimental and therapeutic medicine · 2020Article
- Effect of Berberine fromEvidence-based complementary and alternative medicine : eCAM · 2020Article
- Neuro-Immune Circuits Regulate Immune Responses in Tissues and Organ Homeostasis.Frontiers in immunology · 2020Review
- Management of elderly ulcerative colitis in Japan.Journal of gastroenterology · 2019Review
- The Impact of Inflammatory Bowel Disease in Canada 2018: IBD in Seniors.Journal of the Canadian Association of Gastroenterology · 2019Article
- Management of Ulcerative Colitis in the Elderly.Drugs & aging · 2019Review
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
backgroundUlcerative colitis (UC) can be treated with surgery or medications. Patients often must choose between long-term immunosuppressant therapy or total colectomy. Whether one of these treatment approaches has a mortality benefit is uncertain.
objectiveTo determine whether patients with advanced UC treated with elective colectomy have improved survival compared with those treated with medical therapy.
designRetrospective matched cohort study.
settingData from all 50 states for Medicaid beneficiaries (2000 to 2005), Medicare beneficiaries (2006 to 2011), and dual-eligible persons (2000 to 2011). PATIENTS: 830 patients with UC pursuing elective colectomy and 7541 matched patients with UC pursuing medical therapy. MEASUREMENTS: The primary outcome was time to death. Cox proportional hazards models were used to compare the survival of patients with advanced UC treated with elective colectomy or medical therapy. The models controlled for significant comorbid conditions through matched and adjusted analysis.
resultsThe mortality rates associated with elective surgery and medical therapy were 34 and 54 deaths per 1000 person-years, respectively. Elective colectomy was associated with improved survival compared with long-term medical therapy (adjusted hazard ratio [HR], 0.67 [95% CI, 0.52 to 0.87]), although this result did not remain statistically significant in all sensitivity analyses. Post hoc analysis by age group showed improved survival with surgery in patients aged 50 years or older with advanced UC (HR, 0.60 [CI, 0.45 to 0.79]; P = 0.032 for age-by-treatment interaction). LIMITATIONS: Retrospective nonrandomized analysis is subject to residual confounding. The source cohort was derived from different databases throughout the study. Sensitivity and secondary analyses had reduced statistical power.
conclusionElective colectomy seemed to be associated with improved survival relative to medical therapy among patients aged 50 years or older with advanced UC. PRIMARY FUNDING SOURCE: National Institutes of Health and Agency for Healthcare Research and Quality.
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