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Comparison of 1-Year Colectomy Risk Between the US and Korean Patients with Acute Severe Ulcerative Colitis: A Propensity Score Matching Analysis

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Abstract

Background

Colectomy risk after acute severe ulcerative colitis (ASUC) has not been compared between Eastern and Western countries. We compared the 1-year colectomy risk after ASUC between Korea and the USA.

Methods

Data on patients admitted for ASUC to five tertiary referral hospitals in Korea and Mount Sinai Hospital, New York, the USA, between January 2015 and January 2019 were reviewed retrospectively. For comparability between groups, a 1:1 propensity score matching (PSM) was performed. The primary outcome was colectomy, and secondary outcomes were mortality, readmission, and venous thromboembolism (VTE) within 1-year of the index admission for ASUC. The risk of each outcome was compared using Cox proportional hazards model in pre-matched cohort and Kaplan–Meier analysis with log-rank test in post-matched cohort.

Results

290 ASUC patients were included in the study (121 Korea, 169 the USA). After PSM, 56 patients were selected in each group with no significant differences in baseline variables. At 1 year after ASUC, colectomy was less common in Korea than in the USA [3 (5.4%) vs. 24 (42.9%), p < 0.001]. The cumulative colectomy risk was significantly higher in the USA than in Korea in pre-matched cohort [adjusted hazard ratio 7.89, 95% confidence interval 3.23 to 19.22] and in post-matched cohort (log-rank p < 0.001), while there was no difference in cumulative risk of mortality, readmission, and VTE.

Conclusion

Colectomy risk within 1 year of ASUC is significantly higher in the USA than in Korea. We observed no differences in mortality, readmission, and VTE between the two groups.

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Funding

This work was supported by grants from the National Research Foundation (NRF) of Korea (NRF-2017R1D1A1B03028512, NRF-2020R1F1A1066115).

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Author notes

  1. Eun Soo Kim and Kyeong Ok Kim have contributed equally to this work.

Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, 41944, Korea

    Eun Soo Kim, Hyun Seok Lee, Joon Seop Lee & Sung Kook Kim

  2. Division of Gastroenterology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea

    Kyeong Ok Kim & Byung Ik Jang

  3. Division of Gastroenterology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea

    Eun Young Kim

  4. Division of Gastroenterology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea

    Yoo ** Lee

  5. Division of Gastroenterology, Department of Internal Medicine, Fatima Hospital of Daegu, Daegu, Korea

    Yun ** Jung

  6. Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea

    Sang-Bum Kang

  7. Department of Medicine, Icahn School of Medicine at Mount Sinai, The Henry D. Janowitz Division of Gastroenterology, New York, NY, USA

    Manasi Agrawal, Ryan Ungaro & Jean-Frederic Colombel

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  1. Eun Soo Kim
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Contributions

Guarantor of the article: Eun Soo Kim. ESK and KOK: study design, data collection, data analysis, writing first draft of manuscript. BIJ, EYK, YJL, HSL, JSL, and SKK: collection of clinical data, critical revision of the manuscript, final approval of the version to be submitted. MA, RU, and JFC: study design, data analysis, supervision, critical revision of the manuscript, final approval of the version to be submitted. All authors approved the final version of the manuscript.

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Correspondence to Eun Soo Kim.

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Kim, E.S., Kim, K.O., Jang, B.I. et al. Comparison of 1-Year Colectomy Risk Between the US and Korean Patients with Acute Severe Ulcerative Colitis: A Propensity Score Matching Analysis. Dig Dis Sci 67, 2866–2875 (2022). https://doi.org/10.1007/s10620-021-07130-y

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