Abstract Background Hospital readmissions and colectomy are key indicators of disease control in Ulcerative Colitis (UC). Although therapeutic options have expanded in recent years, it is unclear whether these outcomes have consistently improved over time. We aimed to examine temporal trends in readmission and colectomy rates among patients admitted for exacerbation of UC at a tertiary care center. Methods We conducted a retrospective cohort study of patients admitted to our center for UC exacerbation between 2010 and 2024. Patients were included if they had at least one year of follow-up after index hospitalization. Admission occurring more than one year after the previous one was considered a separate event. Outcomes included readmissions (within 30, 90, and 365 days) as well as colectomy and changes in medical treatment. Temporal trends in readmission and colectomy were tested using population-averaged multivariable logistic generalized estimating equations clustered by patient. Results A total of 227 patients were included representing 292 index hospitalizations. Median age was 34 years (IQR 24–48), 48% female, and 57.7% were Jewish. Median disease duration was 3 years (IQR 0–10). Disease extent was Montreal E3 in 47.6%, E2 in 45.4%, and E1 in 7%. Steroids were administered in 267 hospitalizations (91.4%), 36 (13.5%) of them received salvage therapy, and 26 patients (11.5%) eventually underwent colectomy within one year. Dose escalation occurred in 44 cases (15%), and treatment changed in 106 (36.3%). Colectomy rates declined significantly over the study period (OR per year 0.85, 95% CI 0.74–0.97; p = 0.04). The annual readmission rate was 34.2% (5.8% within 30 days and 23.6% within 90 days), and no significant linear trend was observed over time (OR per year 0.96, 95% CI 0.90–1.03, Figure 1). The main risk factor for undergoing surgery was prior exposure to anti-TNF therapy, likely reflecting greater underlying disease severity (OR = 9.99, CI 3.34-29.88, Table 1). Conclusion Among patients admitted for UC exacerbations, colectomy rates decreased over time while readmissions did not change significantly, suggesting that expanding medical treatment options are increasingly used as alternatives to surgery. Moreover, continued efforts are needed to optimize acute and post-discharge management strategies in UC, with particular attention to high-risk patients such as those previously exposed to anti-TNF therapy. Conflict of interest: Dr. Postnikov, Maria: No conflict of interest Weisshof, Roni: No conflict of interest Gorelik, Yuri: No conflict of interest Ben Hur, Dana: No conflict of interest Waterman, Matti: No conflict of interest Koifman, Eduard: No conflict of interest
Postnikov et al. (Thu,) studied this question.