Incidence and clinical impact of perianal disease in patients with ulcerative colitis: A nationwide population-based study

Eun Mi Song, Ho Su Lee, Ye Jee Kim, Eun Hye Oh, Nam Seok Ham, Jeongseok Kim, Sung Wook Hwang, Sang Hyoung Park, Dong Hoon Yang, Byong Duk Ye, Jeong Sik Byeon, Seung Jae Myung, Suk Kyun Yang

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7 Scopus citations


Background and Aim: The risk and clinical impact of perianal disease (PAD) in ulcerative colitis (UC) patients have not been fully evaluated. We investigated the incidence of PAD in UC patients and compared clinical characteristics and outcomes of UC according to the presence of PAD. Methods: We performed a nationwide population-based cohort study and a hospital-based cohort study. Using the 2010–2014 data from the Korean National Health Insurance claims database, we calculated incidence rates and standardized incidence ratios of PAD in UC patients compared with the general population. We evaluated the clinical characteristics and outcomes of UC patients with PAD in both population-based and hospital-based cohorts. To reduce clinically meaningful confounding factors, we also conducted matched analyses. Results: In the population-based cohort, the incidence rate and standardized incidence ratio of PAD in UC patients were 3.74/1000 person-years (95% confidence interval, 3.25–4.31) and 2.88 (95% confidence interval, 2.50–3.32), respectively. In the hospital-based cohort, the cumulative probabilities of PAD at 1, 5, 10, and 20 years after diagnosis were 1.0%, 2.3%, 4.0%, and 6.3%, respectively. In both population-based and hospital-based cohorts, UC patients with PAD showed higher proportions of corticosteroid use and extensive colitis at diagnosis. The requirements for anti-tumor necrosis factor agents and colectomy were significantly higher in UC patients with PAD before and after matched analysis. Conclusions: The risk of PAD is higher in UC patients than in the general population. UC patients with PAD have distinct clinical features and poor outcomes, as indicated by the greater need for UC-related medications and colectomy.

Original languageEnglish
Pages (from-to)1011-1017
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number6
StatePublished - Jun 2019

Bibliographical note

Funding Information:
Yang received a research grant from Janssen Korea Ltd.; however, this funding was not related to the topic of this study. The remaining authors have no conflicts of interest to declare. Financial support: This work was supported by a Korean Health Technology R&D Project grant

Funding Information:
We thank the Korean Health Insurance Review and Assessment Service for providing the insurance claims data. This study used the National Health Information Database (NHIS-2018-2-059) created by the National Health Insurance Service.

Publisher Copyright:
© 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd


  • anus diseases
  • fistula
  • incidence
  • ulcerative colitis


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