Background: @entity31 ( @entity31 ) can be treated with surgery or medications. @entity1 often must choose between long-term immunosuppressant therapy or total colectomy. Whether one of these treatment approaches has a mortality benefit is uncertain. Objective: To determine whether @entity1 with advanced @entity31 treated with elective colectomy have improved survival compared with those treated with medical therapy. Design: Retrospective matched cohort study. Setting: Data from all 50 states for Medicaid beneficiaries (2000 to 2005), Medicare beneficiaries (2006 to 2011), and dual-eligible @entity1 (2000 to 2011). @entity1 : 830 @entity1 with @entity31 pursuing elective colectomy and 7541 matched @entity1 with @entity31 pursuing medical therapy. Measurements: The primary outcome was time to @entity204 . Cox proportional hazards models were used to compare the survival of @entity1 with advanced @entity31 treated with elective colectomy or medical therapy. The models controlled for significant comorbid conditions through matched and adjusted analysis. Results: The mortality rates associated with elective surgery and medical therapy were 34 and 54 deaths per 1000 @entity1 -years, respectively. Elective colectomy was associated with improved survival compared with long-term medical therapy (adjusted hazard ratio [HR], 0.67 [95% CI, 0.52 to 0.87]), although this result did not remain statistically significant in all sensitivity analyses. Post hoc analysis by age group showed improved survival with surgery in @entity1 aged 50 years or older with advanced @entity31 (HR, 0.60 [CI, 0.45 to 0.79]; P   = 0.032 for age-by-treatment interaction). Limitations: Retrospective nonrandomized analysis is subject to residual confounding. The source cohort was derived from different databases throughout the study. Sensitivity and secondary analyses had reduced statistical power. Conclusion: Elective colectomy seemed to be associated with improved survival relative to medical therapy among @entity1 aged 50 years or older with advanced @entity31 . Primary Funding Source: National Institutes of Health and Agency for Healthcare Research and Quality.

Mortality Associated With Medical Therapy Versus Elective Colectomy in XXXX : A Cohort Study.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'person', 'persons'] @entity31 :: ('MESH:D003093', 'Disease') :: ['UC', 'Ulcerative colitis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity31 :: (MESH:D003093,Disease) :: ['Ulcerative Colitis']
