Related Experiment Videos

US estimates of hospitalized pediatric patients with ulcerative colitis: implications for multicenter clinical

Stephen L Guthery1, Lydia Dong, J Michael Dean

  • 1Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA. Stephen.Guthery@hsc.utah.edu

Inflammatory Bowel Diseases
|May 31, 2008
PubMed

Insights

Half of hospitalized pediatric ulcerative colitis (UC) patients are treated at high-volume centers. Approximately 5 such centers are sufficient for clinical trials in refractory UC.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Research Epidemiology

Background:

  • Optimal clinical management for pediatric ulcerative colitis (UC) is evolving.
  • Limited data exists on the number of US children hospitalized with UC.
  • The Kids' Inpatient Database (KID) was analyzed to address this gap.

Purpose of the Study:

  • To estimate the distribution of hospitalized pediatric UC patients in the US.
  • To determine the number of high-volume hospitals treating these patients.
  • To assess sample sizes for clinical research in pediatric UC.

Main Methods:

  • Analysis of the 2003 Kids' Inpatient Database (KID).
  • Inclusion of subjects under 18 years old with ICD-9 codes for UC (556.0-556.9).
  • Colectomy defined by procedure code 45.8; weighted estimates generated; simulation studies performed.

Main Results:

  • 2311 UC cases identified; mean age 13.1 years; 9% underwent colectomy.
  • 1008 UC cases treated at high-volume hospitals, primarily children's hospitals.
  • Simulations indicated ~5 high-volume hospitals needed for refractory UC pilot trials.

Conclusions:

  • Nearly half of hospitalized pediatric UC patients are treated at a few high-volume centers.
  • Approximately 5 high-volume centers are adequate for pilot clinical trials in hospitalized refractory UC patients.
Abstract

Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies

Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation.