{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:30:43Z","timestamp":1762176643363},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,11,1]],"date-time":"2012-11-01T00:00:00Z","timestamp":1351728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DK060617","DK077734","HD052885"],"award-info":[{"award-number":["DK060617","DK077734","HD052885"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005570","name":"Takeda Pharmaceuticals North America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005570","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives:<\/jats:title><jats:p>Few clinical predictors are associated with definitive proctocolectomy in children with ulcerative colitis (UC). The purpose of the present study was to identify clinical predictors associated with surgery in children with UC using a disease\u2010specific database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Children diagnosed with UC at age &lt;18 years were identified using the Pediatric Inflammatory Bowel Disease Consortium (PediIBDC) database. Demographic and clinical variables from January 1999 to November 2003 were extracted alongside incidence and surgical staging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Review of the PediIBDC database identified 406 children with UC. Approximately half were girls (51%) with an average age at diagnosis of 10.6 \u00b1 4.4 years in both boys and girls. Average follow\u2010up was 6.8 (\u00b14.0) years. Of the 57 (14%) who underwent surgery, median time to surgery was 3.8 (interquartile range 4.9) years after initial diagnosis. Children presenting with weight loss (hazard ratio [HR] 2.55, 99% confidence interval [CI] 1.21\u20135.35) or serum albumin &lt;3.5 g\/dL (HR 6.05, 99% CI 2.15\u201317.04) at time of diagnosis and children with a first\u2010degree relative with UC (HR 1.81, 99% CI 1.25\u20132.61) required earlier surgical intervention. Furthermore, children treated with cyclosporine (HR 6.11, 99% CI 3.90\u20139.57) or tacrolimus (HR 3.66, 99% CI 1.60\u20138.39) also required earlier surgical management. Other symptoms, laboratory tests, and medical therapies were not predictive for need of surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>Children with UC presenting with hypoalbuminemia, weight loss, a family history of UC, and those treated with calcineurin inhibitors frequently require restorative proctocolectomy for definitive treatment. Early identification and recognition of these factors should be used to shape treatment goals and initiate multidisciplinary care at the time of diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e3182619d26","type":"journal-article","created":{"date-parts":[[2012,12,17]],"date-time":"2012-12-17T20:01:15Z","timestamp":1355774475000},"page":"534-540","source":"Crossref","is-referenced-by-count":27,"title":["Predictors of Proctocolectomy in Children With Ulcerative Colitis"],"prefix":"10.1002","volume":"55","author":[{"given":"Lorraine I.","family":"Kelley\u2010Quon","sequence":"first","affiliation":[{"name":"Mattel Children's Hospital University of California, San Francisco San Francisco CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard C.","family":"Jen","sequence":"additional","affiliation":[{"name":"Mattel Children's Hospital University of California, San Francisco San Francisco CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David 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Healthcare of Atlanta Atlanta GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harland S.","family":"Winter","sequence":"additional","affiliation":[{"name":"MassGeneral Hospital for Children Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melvin B.","family":"Heyman","sequence":"additional","affiliation":[{"name":"UCSF Benioff Children's Hospital University of California, San Francisco San Francisco CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin D.","family":"Gold","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine Atlanta GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen B.","family":"Shew","sequence":"additional","affiliation":[{"name":"Mattel Children's Hospital University of California, San Francisco San Francisco 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