Endoscopic study of patients with inflammatory bowel diseases in Northwestern Greece (Doctoral thesis)
Background: Pseudopolyps in ulcerative colitis (UC) are considered as indicators of previous episodes of severe inflammation and ulceration of the mucosa. The aim of the study was to investigate the long-term outcomes of patients treated for UC, with or without pseudopolyps. Methods: This was a retrospective single-center study. Consecutive patients with UC and available endoscopic data from 2000 until 2017 were eligible for the study and were followed until June 2017. Patients with incomplete medical/endoscopic charts or interrupted follow up were excluded from the study. Primary outcomes included time to treatment escalation, treatment escalation to biological agents or surgery, and UC-related hospitalization. Secondary outcome included the association of pseudopolyps with bowel stenosis. Results: Eighty-three UC patients were included in the study, of whom 25 (30%) had pseudopolyps. The median duration of follow up was 2.8 years (interquartile range: 1.1-4.9). Multiple Cox regression analysis identified the presence of pseudopolyps as the only variable independently associated with treatment escalation (hazard ratio [HR] 2.3, 95% confidence interval [CI] 1.2-4.3; p=0.014) and escalation to biological agents or surgery (HR 6.3, 95%CI 1.9-20.7; p=0.002). The presence of pseudopolyps was marginally associated with bowel stenosis during follow up (OR 4.6; 95% Cl: 1-21; p=0.050). Only extensive colitis was associated with increased need for UC-related hospitalization (HR 1.9; 95% Cl:1.1-3.6, p=0.040) and not the pseudopolyps (p=0.434). Conclusion: This retrospective single-center study provides the first preliminary evidence that patients with UC and pseudopolyps may represent a subpopulation with a higher inflammatory burden and a greater need for treatment escalation, including to biological agents or surgery. Large, prospective multicenter studies are certainly warranted to confirm these findings.
|Institution and School/Department of submitter:||Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής|
|Keywords:||Ενδοσκόπηση,Ιδιοπαθής φλεγμονώδης πάθηση του εντέρου,Ψευδοπολύποδες,Βιολογικοί παράγοντες,Endoscopy,Inflammatory bowel diseases,Pseudopolyps,Biological treatment|
|Appears in Collections:||Διδακτορικές Διατριβές|
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|Δ.Δ. ΠΟΛΙΤΗΣ ΔΗΜΗΤΡΙΟΣ 2019.pdf||1.69 MB||Adobe PDF||View/Open|
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