Colectomy rates for Ulcerative Colitis differ between ethnic groups: results from a 15-year nationwide cohort study
File(s)
Published version
Author(s)
Misra, R
Askari, A
Faiz, O
Arebi, N
Type
Journal Article
Abstract
Introduction
Previous epidemiological studies suggest a higher rate of pan-colonic disease in South Asians (SA) compared with White Europeans (WE). The aim of the study was to compare colectomy rates for ulcerative colitis (UC) in SA to WE.
Methods
Patients with UC were identified from a national administrative dataset (Hospital Episode Statistics - HES) between 1997-2012 according to ICD-10 diagnosis code K51 for UC. The colectomy rate for each ethnic group was calculated as the proportion of patients who underwent colectomy from the total UC cases for that group.
Results
Of 212,430 UC cases, 73,318 (35.3%) were coded for ethnicity. There was no significant difference in the colectomy rate between SAs and WE (6.93% vs 6.90%). Indians had a significantly higher colectomy rate than WE (9.8% vs 6.9%, p<0.001). Indian patients were 21% more likely to require colectomy for UC compared with WE group (OR 1.21, 95% CI 1.04-1.42, p=0.001). SAs undergoing colectomy were younger than WE. (median age; Bangladeshis – 29 years, Pakistanis - 35 years and Indians - 39 years, compared with WE – 48 years, p<0.001).
Conclusions
Given the limitations in coding, the colectomy rate in this cohort was higher in Indians compared to WE. Although there were differences in colectomy rates between the SA ethnic groups all had a colectomy for UC at a younger median age than WE. A prospectively recruited ethnic cohort study will decipher whether this reflects a more aggressive phenotype or is due to other confounding factors.
Previous epidemiological studies suggest a higher rate of pan-colonic disease in South Asians (SA) compared with White Europeans (WE). The aim of the study was to compare colectomy rates for ulcerative colitis (UC) in SA to WE.
Methods
Patients with UC were identified from a national administrative dataset (Hospital Episode Statistics - HES) between 1997-2012 according to ICD-10 diagnosis code K51 for UC. The colectomy rate for each ethnic group was calculated as the proportion of patients who underwent colectomy from the total UC cases for that group.
Results
Of 212,430 UC cases, 73,318 (35.3%) were coded for ethnicity. There was no significant difference in the colectomy rate between SAs and WE (6.93% vs 6.90%). Indians had a significantly higher colectomy rate than WE (9.8% vs 6.9%, p<0.001). Indian patients were 21% more likely to require colectomy for UC compared with WE group (OR 1.21, 95% CI 1.04-1.42, p=0.001). SAs undergoing colectomy were younger than WE. (median age; Bangladeshis – 29 years, Pakistanis - 35 years and Indians - 39 years, compared with WE – 48 years, p<0.001).
Conclusions
Given the limitations in coding, the colectomy rate in this cohort was higher in Indians compared to WE. Although there were differences in colectomy rates between the SA ethnic groups all had a colectomy for UC at a younger median age than WE. A prospectively recruited ethnic cohort study will decipher whether this reflects a more aggressive phenotype or is due to other confounding factors.
Date Issued
2016-12-01
Date Acceptance
2016-11-28
Citation
Canadian Journal of Gastroenterology and Hepatology, 2016, 2016
ISSN
2291-2797
Publisher
Hindawi Publishing Corporation
Journal / Book Title
Canadian Journal of Gastroenterology and Hepatology
Volume
2016
Copyright Statement
© 2016 Ravi Misra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (https://creativecommons.org/licenses/by/4.0/)
Subjects
Asian Continental Ancestry Group
Cohort Studies
Colectomy
Colitis, Ulcerative
Databases, Factual
Ethnic Groups
European Continental Ancestry Group
Female
Humans
Male
Retrospective Studies
United Kingdom
Publication Status
Published
Article Number
8723949