P2128 - Outcomes of Patients Admitted With Acute, Severe Ulcerative Colitis on Established Biologic Therapy: A Retrospective Analysis from a Tertiary Referral Hospital

Nasruddin Sabrie, MD¹, Manisha Jogendran, Bsc, MD², Rohit Jogendran, MD, BSc¹, Laura E.. Targownik, MD, MSHS^1
1University of Toronto, Toronto, ON, Canada; ²Queen's University, Kingston, ON, Canada

Introduction: Acute, severe, ulcerative colitis (ASUC) is a phenotype of UC that is associated with significant morbidity. In steroid refractory ASUC, salvage medical therapy with infliximab is recommended to reduce the risk of colectomy. However, the evidence supporting this practice is based on cohorts naïve to biologics. Consequently, the management of patients on established biologic or small molecule therapy (EBST) with ASUC is not well defined.

Methods: We conducted a retrospective chart review of patients admitted with ASUC to Mount Sinai Hospital (MSH) in Toronto, Ontario from January 2018 until January 2022. Included subjects were considered to be on EBST if they had received a dose of these agents within 56 days prior to admission. Our primary outcome was the mean difference in hospital length of stay (HLOS) between the two groups. Additional outcomes of interest include rates of surgical consultation, rates of inpatient colectomies, and 90-day readmission rates.

Results: Of the 185 admission for ASUC, 76 were on EBST and 109 were not. Baseline characteristics were similar between the two groups. There were no significant differences in hospital length of stay (7.46 days vs 7.45 days p = 0.52) or in-hospital colectomy rates between the two groups. Patients on EBST had higher rates of surgical consultation (36.8% vs 8.3% p< 0.01) prior to discharge and 90-day readmission rates (26.3% vs 13.8% p = 0.03).

Discussion: Patients on EBST were more likely to receive a surgical consultation during their admission and had higher rates of readmission at 90 days. ASUC remains a challenging clinical entity to manage and further studies evaluating the underlying factors that contribute to readmission in patients on EBST in hospital are needed.



Disclosures:


Nasruddin Sabrie, MD¹, Manisha Jogendran, Bsc, MD², Rohit Jogendran, MD, BSc¹, Laura E.. Targownik, MD, MSHS¹. P2128 - Outcomes of Patients Admitted With Acute, Severe Ulcerative Colitis on Established Biologic Therapy: A Retrospective Analysis from a Tertiary Referral Hospital, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.