Non-response to intravenous corticosteroids for acute severe UC can be predicted after the first 72 hours of treatment. However, about a third of non-responders receive systemic steroid monotherapy beyond 7 days. This prolonged use of ineffective systemic steroids may unnecessarily lengthen hospitalization days and increase risk of postoperative complications in those who eventually require colectomy.

Conditions: Ulcerative colitis (UC)

Procedures: Colectomy

Treatments: Intravenous corticosteroids

Sources

• Bitton A, et al. Treatment of hospitalized adult patients with severe ulcerative colitis: Toronto consensus statements. Am J Gastroenterol. 2012 Feb;107(2):179-94. (PubMed)
• Kaplan GG, et al. Impact of hospital volume on postoperative morbidity and mortality following a colectomy for ulcerative colitis. Gastroenterology. 2008 Mar;134(3):680-7. (PubMed)
• Nguyen GC, et al. Quality of Care and Outcomes Among Hospitalized Inflammatory Bowel Disease Patients: A Multicenter Retrospective Study. Inflamm Bowel Dis. 2017 May;23(5):695-701. (PubMed)
• Randall J, et al. Delayed surgery for acute severe colitis is associated with increased risk of postoperative complications. Br J Surg. 2010 Mar;97(3):404-9. (PubMed)