J Gastrointestin Liver Dis, September 2015 Vol. 24 No 3: 287-292 1) 1 st Department of Medicine, Semmelweis University, Budapest; 2) Department of Medicine, Csolnoky F. Province Hospital, Veszprem; 3) Department of Medicine, Grof Eszterhazy Hospital, Papa Hungary Address for correspondence: Peter Laszlo Lakatos, MD, PhD 1 st Department of Medicine, Semmelweis University, Koranyi S. 2/A, H-1083 Hungary lakatos.peter_laszlo@med. semmelweis-univ.hu Received: 03.06.2015 Accepted: 18.08.2015 Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012) Petra A. Golovics 1 , Laszlo Lakatos 2 , Michael D. Mandel 1 , Barbara D. Lovasz 1 , Zsuzsanna Vegh 1,2 , Zsuzsanna Kurti 1 , Istvan Szita 2 , Lajos S. Kiss 1 , Mihaly Balogh 3 , Tunde Pandur 2 , Peter L. Lakatos 1 INTRODUCTION Infammatory bowel diseases (IBD) are chronic, progressive diseases. Ulcerative colitis (UC) has a variable course; the majority of patients experience multiple relapses repetitively, while some patients experience chronic continuous symptoms, eventually developing complications with multiple possible outcomes from ORIGINAL PAPER ABSTRACT Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of frst UC-related hospitalization were 28.6%, 53.7% and 66.2% and of frst re- hospitalization were 23.7%, 55.8% and 74.6% afer 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for frst hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a signifcant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specifc disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course. Key words: ulcerative colitis – population-based – hospitalization – disease course – predictors. Abbreviations: AZA: azathioprine; EIM: extraintestinal manifestation; IBD: infammatory bowel disease; TNF: tumor necrosis factor; UC: ulcerative colitis. Available from: http://www.jgld.ro/wp/archive/y2015/n3/a5 DOI: http://dx.doi.org/10.15403/jgld.2014.1121.243.pag necessitating hospitalization or surgery. Te majority of UC patients are managed on an outpatient basis [1]; yet the number of patients requiring colectomy is continually increasing. In addition, medical and/or surgical hospitalization events contribute signifcantly to the economic burden of the disease [2]. In UC, hospitalization usually refects disease severity and lack of response to medical therapy, and is associated with the need for colectomy and mortality. In the Oxford cohort, the need for hospitalization for acute severe colitis was the most important predictor for colectomy [3]. Limited data are available on hospitalization and/or re- hospitalization rates in UC in population-based cohorts.