Clinical characteristics and long-term prognosis of elderly onset ulcerative colitis

Background and AimThe aim of this study was to investigate the clinical characteristics and prognosis of patients with elderly onset ulcerative colitis (EOUC), a new growing subgroup of UC. MethodsThis study retrospectively analyzed 3060 South Korean UC patients diagnosed between 1977 and 2014. The clinical characteristics and prognosis of EOUC, defined as UC in those aged 60years at diagnosis, were compared with those of non-EOUC (NEOUC). ResultsAmong the 3060 patients, 226 were diagnosed with EOUC (7.4%, median age at diagnosis 65.9years [interquartile range, 62.9-68.7years], 58.4% male). The frequency of EOUC increased from 3.9% in the interval 1977-1999 to 9.7% in the interval 2008-2014 (P<0.001). There were more ex-smokers in the EOUC than in the NEOUC group (44.2% vs 19.9%, P<0.001). In the EOUC group, extensive colitis at diagnosis, and the maximum extent thereof, was less than in the NEOUC group (13.7% vs 22.6%, P=0.002, and 34.5% vs 42.5%, P=0.011, respectively). The 10-year cumulative colectomy rate was significantly higher in the EOUC than in the NEOUC group (12.6% vs 7.7%, P=0.015). UC-related and all-cause mortality were higher in the EOUC than in the NEOUC group (3.5% vs 0.6%, P<0.001, and 12.4% vs 1.8%, P<0.001, respectively). ConclusionElderly onset ulcerative colitis patients are likely to exhibit distinct features both at diagnosis and during follow-up. It is necessary to pay more attention to, and to conduct further studies on, this particular group of patients.