Older adults with acute severe ulcerative colitis have similar steroid non-response and colectomy rates as younger adults

Table 1 Baseline characteristics of patients in the two groups (≥ 60 years and < 60 years)

	≥ 60 yr (n = 45)	< 60 yr (n = 181)	P value
Female, n (%)	22 (48.9)	88 (48.6)	1
Median age (yr)	71 (63-77)	32 (24-42)	< 0.0011
Median disease duration (yr)	2.5 (0-5)	2 (0.1-6)	0.941
Index presentation of UC as ASUC (n, %)	14 (31.1)	45 (24.9)	0.45
Median follow up post admission for ASUC (wk)	104 (20-160)	74 (30-168)	0.971
Median symptom duration before admission (d)	14 (7-24)	14 (5-28)	0.591
Median length of stay (d)	10 (7-19)	9 (7-13.5)	0.221
Disease extent, n (%)			0.072
Left-sided colitis	8 (17.8)	54 (29.8)
Pancolitis	37 (82.2)	127 (70.2)
Toxic megacolon, n (%)	0	4 (2.2)	0.41
Extraintestinal manifestations, n (%)	2 (4.4)	31 (17.1)	0.02
Superimposed clostridium difficile, n (%)	3 (6.7)	6 (3.3)	0.26
Smoking status, n (%)			0.037
Never	21 (46.7)	121 (66.9)
Current	6 (13.3)	17 (9.4)
Former	18 (40.0)	43 (23.8)
5-aminosalicyclate use, n (%)			0.86
Current	24 (53.3)	100 (55.2)
Never	14 (31.1)	49 (27.1)
Intolerant/ceased	7 (15.6)	32 (17.7)
Current thiopurine use, n (%)	6 (13.3)	29 (16.0)	0.29
Current methotrexate use, n (%)	1 (2.2)	2 (1.1)	0.16
Anti-TNF antagonist use, n (%)			0.74
Current	6 (13.3)	23 (12.7)
Never	37 (82.2)	134 (74.0)
Intolerant	1 (2.2)	6 (3.3)
Secondary loss of response	1 (2.2)	18 (9.9)
Vedolizumab use, n (%)			0.024
Current	8 (17.8)	9 (5.0)
Never	35 (77.8)	163 (90.0)
Intolerant	0	4 (2.2)
Secondary loss of response	2 (4.4)	5 (2.8)
Biologics on admission, n (%)	14 (31.0)	35 (19.4)	0.11
Oral steroids at admission, n (%)	15 (33.3)	78 (43.1)	0.31
Median admission UCEIS	5.5 (5-7)	6 (5-7)	0.821
Median serum albumin on day of admission (g/L)	31 (27-34)	33 (29-38)	0.0051
Median haemoglobin on day of admission (g/L)	126 (111-135)	124 (108-139)	0.921
Median platelet count on day of admission (units)	333.5 (277-386)	393 (293-500)	0.0061
Median CRP on day of admission (mg/L)	69 (33-121)	54 (30-99)	0.341
Median admission faeces calprotectin (mcg/g)	2400 (1600-4600)	2850 (1400-5300)	0.481
Median stool frequency on day of admission	10 (7-15)	10 (8-18)	0.411

¹Wilcoxon Ranksum test.

Continuous variables reported as median with interquartile range. UC: Ulcerative colitis; ASUC: Acute severe ulcerative colitis; UCEIS: Ulcerative colitis endoscopic index of severity; CRP: C-reactive protein; TNF: Tumour necrosis factor.

Table 2 Summary of primary and secondary outcomes of older vs younger adults with acute severe ulcerative colitis, n (%)

	≥ 60 yr, n = 45	< 60 yr, n = 181	Crude RD (95%CI)	Crude RR (95%CI)	Adjusted RR1 (95%CI)	OR (95%CI)
Primary outcome: Steroid non-response	19 (42.2%)	85 (47%)	-0.47 (-0.21 to 0.11)	0.89 (0.61-1.30)	0.99 (0.34-2.90)	0.82 (0.43-1.58)
Response to medical rescue therapy	13 (76.5%)	66 (85.7%)	-0.09 (-0.31 to 0.12)	0.89 (0.67-1.17)	-	0.54 (0.16-1.85)
Colectomy same admission	6 (13.3%)	19 (10.5%)	0.028 (-0.08 to 0.13)	1.27 (0.53-2.99)	1.43 (0.34-6.06)	1.31 (0.50-3.41)
Colectomy at 3 mo	9 (20.9%)	30 (17.6%)	-0.03 (-0.10 to 0.16)	1.18 (0.61-2.3)	1.31 (0.32-5.30)	1.23 (0.54-2.80)
Colectomy at 12 mo	9 (24.3%)	42 (28.8%)	-0.04 (-0.20 to 0.11)	0.85 (0.45-1.57)	1.2 (0.29-4.97)	0.79 (0.35-1.80)

¹Adjusted relative risk for sex, disease duration, smoking status, disease extent, current biologic use.

RD: Risk difference; RR: Relative risk; aRR: Adjusted relative risk; OR: Odds ratio.