Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2025; 17(8): 109326
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.109326
Preoperative performance status was associated with postoperative fatal complications in elderly patients with refractory ulcerative colitis
Yuki Horio, Motoi Uchino, Yusuke Tomoo, Kazunori Nomura, Kentaro Nagano, Kurando Kusunoki, Ryuichi Kuwahara, Kei Kimura, Toshiyuki Sato, Kozo Kataoka, Masataka Igeta, Shinichiro Shinzaki, Masataka Ikeda, Hiroki Ikeuchi
Yuki Horio, Motoi Uchino, Yusuke Tomoo, Kazunori Nomura, Kentaro Nagano, Kurando Kusunoki, Ryuichi Kuwahara, Kei Kimura, Kozo Kataoka, Masataka Ikeda, Hiroki Ikeuchi, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan
Toshiyuki Sato, Shinichiro Shinzaki, Department of Gastroenterology, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan
Masataka Igeta, Department of Biostatistics, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan
Author contributions: Horio Y was responsible for conception and design of the study; acquisition, analysis, and interpretation of data; and drafting of the article; Igeta M was responsible for analysis and interpretation of data; Tomoo Y, Nomura K, Nagano K, Kusunoki K, Kuwahara R, Kimura K, Kataoka K, and Sato T were responsible for conception and design of the study; acquisition, analysis, and interpretation of data; Uchino M, Shinzaki S, Ikeda M, and Ikeuchi H were responsible for acquisition of data, drafting or critical revision of the article for important intellectual content, and final approval.
Institutional review board statement: All human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All study protocols were approved by the institutional review board of Hyogo Medical University (No. 3811).
Informed consent statement: Informed consent and agreement for the use of patient data were obtained before surgery was commenced. Written informed consent was obtained using the opt-out method. An opt-out informed consent protocol was used for the use or collection of participant data for research purposes. This consent procedure was reviewed and approved by the institutional review board of Hyogo Medical University (approval number: 3811; date of decision: June 18, 2021).
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: sharing statement: All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuki Horio, MD, PhD, Lecturer, Department of Gastroenterological Surgery, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan. yu-horio@hyo-med.ac.jp
Received: May 8, 2025
Revised: May 19, 2025
Accepted: June 12, 2025
Published online: August 27, 2025
Processing time: 110 Days and 6.6 Hours
Core Tip

Core Tip: This study identified low body mass index (< 17 kg/m²) and poor Eastern Cooperative Oncology Group performance status (≥ 3) as independent risk factors for fatal postoperative complications in elderly patients with refractory ulcerative colitis. The most common fatal complication was pneumonia due to disuse syndrome. These findings emphasize the importance of early surgical intervention before significant functional decline or weight loss occurs. In the era of complex biologic therapies, these simple, clinically assessable markers offer practical guidance for timely surgical decision-making in high-risk elderly patients.