P124 The bottom line on ulcerative proctitis: an 11-year analysis of patient outcomes from a UK teaching hospital
Notice bibliographique
Résumé
<h3>Introduction</h3> Ulcerative proctitis (UP), is a localized manifestation of ulcerative colitis (UC) confined to the rectum.<sup>1</sup> Between 25–55% of patients diagnosed with UC initially present with UP.<sup>2</sup>Patients with UP exhibit more favourable prognoses compared to those with extensive UC though up to 30% of those with UP progress to more extensive colitis over time.<sup>3</sup> This retrospective analysis explores the clinical trajectories of patients with UP referred to a UK teaching hospital over 11 years. <h3>Methods</h3> This study retrospectively identified patients diagnosed with UP between 2012 and 2023 at a medium-sized UK teaching hospital. Patient data, extracted from electronic health records, were analysed using descriptive statistics. <h3>Results</h3> We identified 176 patients with UP (56% male), with a median diagnostic age of 56.5 years (IQR, 43–76). The median follow-up period was 3.5 years (IQR, 1–7). At diagnosis, 13.4% (n=23) were active smokers. Endoscopic severity was classified as mild in 67 cases (62.6%) and moderate to severe in 60 (56%) of the 107 patients with available data. As initial management, 41 patients (23.2%) received topical 5-ASA, 85 (48.3%) received oral 5-ASA, 10 (5.6%) received topical steroids, and 27 (15.3%) no treatment. Treatment escalation was required for 30 patients (17.0%), with a median time from diagnosis to escalation of 12 months (IQR, 12–24). 23 patients (13.1%) had azathioprine, and 18 (10.2%) required biologics, with 4 (2.2%) needing second-line biologics. The specific biologics used were infliximab (n=7), vedolizumab (n=6), adalimumab (n=2), golimumab (n=2), and ustekinumab (n=1). Four patients (2.2%) underwent surgical resection. A total of 71 patients (40%) were discharged back to primary care after a median follow-up of 18.5 months (IQR, 8–48), and 3 (1.7%) were referred back to secondary care. <h3>Conclusion</h3> UP predominantly exhibits a mild clinical course, with a significant proportion of patients responding adequately to first-line therapy. Our findings suggest that patients with stable UP, adequately managed on 5-ASA, could be discharged to primary care after 12–18 months’ follow-up. Future research should focus on identifying predictors of 5-ASA failure in UP. <h3>References</h3> Satsangi J, Silverberg MS, Vermeire S, <i>et al.</i> The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. <i>Gut</i> 2006;<b>55</b>:749–753. Meucci G, Vecchi M, Astegiano M, <i>et al.</i> The natural history of ulcerative proctitis: a multicenter, retrospective study. <i>Am J Gastroenterol</i> 2000;<b>95</b>:469–473. Kim B, Park SJ, Hong SP, <i>et al.</i> Proximal disease extension and related predicting factors in ulcerative proctitis. <i>Scand J Gastroenterol</i>. 2014 Feb;<b>49</b>(2):177–83.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».