E0089 - Variation in Colectomy Rates in Ulcerative Colitis

Tamer Zahdeh, MD¹, Daniel Elias, BA², Ani Nacharian, MD³, Blanka Bortely, MD¹, Avinaash Raja Sager, MBBS⁴, Sanitha Pulapattassery, MBBS⁵, Mohammad Rizwan Alam, MBBS⁶, Arjun Narayanan, MBBS⁷, Sameh Elias, MD¹, Simcha Weissman, DO^8
1Hackensack Meridian Health - Palisades Medical Center, North Bergen, NJ; ²Rutgers New Jersey Medical School, Union City, NJ; ³HMH Palisades, North Bergen, NJ; ⁴Jawaharlal Nehru Medical College, Belgaum, Karnataka, India; ⁵Rangaraya Medical College, Burtonsville, MD; ⁶Arghakhanchi Hospital Private Limited, Siraha, Sagarmatha, Nepal; ⁷National Health Mission, Kerala, Sayre, PA; ⁸HMH-PMC, North Bergen, NJ

Introduction: Data regarding inter-regional colectomy rates in patients with ulcerative colitis (UC) remains
largely unknown. Herein, we sought to systematically review the global variation in the rates of
colectomy in patients with UC.

Methods: A comprehensive search analysis was performed using the electronic databases
MEDLINE/PubMed, EMBASE, and Cochrane through May 2020, to identify all full-text,
randomized controlled trials (RCTs) and cohort studies pertaining to colectomy rates in adult
patients with UC. We followed PRISMA and AMSTAR 2 guidance for conducting our
systematic review. Outcomes included continent based demographic data and variation in
colectomy rates. All articles were screened for bias using the Newcastle-Ottawa Scale. To
identify the region-specific proportion of patients undergoing colectomy, data were plotted and
median overall proportions were generated.

Results: Our literature search identified 1249 articles, of which 77 studies met inclusion criteria and were
eligible for review. The median overall proportion of persons with UC whom underwent a
colectomy in studies was 17% (range: 1.6%-71%). Median age at UC diagnosis was scarcely

reported and could not be adequately assessed. While the median proportion of persons with UC
whom underwent colectomy was 38%, 31%, and 14% in Oceania, North America, and Europe
respectively; Africa, Asia, and South America saw median colectomy rates as low as 10%, 8%,
and 3%, respectively (Table 1).

Discussion: Considerable inter-regional differences were observed regarding colectomy rates in patients with
UC. As such, the development of homogenous evidence-based guidelines accounting for the
geographic differences in managing patients with UC is needed. Additionally, as a paucity of
data on colectomy exists outside the North American and European continents, future
studies—particularly in less studied locales—are warranted.



Disclosures:


Tamer Zahdeh, MD¹, Daniel Elias, BA², Ani Nacharian, MD³, Blanka Bortely, MD¹, Avinaash Raja Sager, MBBS⁴, Sanitha Pulapattassery, MBBS⁵, Mohammad Rizwan Alam, MBBS⁶, Arjun Narayanan, MBBS⁷, Sameh Elias, MD¹, Simcha Weissman, DO⁸. E0089 - Variation in Colectomy Rates in Ulcerative Colitis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.