{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:18:40Z","timestamp":1789600720963,"version":"build-2803163510"},"reference-count":58,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The medical management of ulcerative colitis (UC) is evolving. However, colectomy may be required in severe or refractory cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To provide contemporary evidence on medication usage and surgery for UC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An incident cohort of patients newly diagnosed with UC from 2003 to 2020 was identified using computerised health records. The cumulative incidence of colectomy and medication use was calculated using Kaplan\u2013Meier methods and compared across 3 time periods. We calculated 90\u2010day post\u2010operative mortality using life tables. Cox regression was used to model the risks of surgery and mortality, adjusting for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>33,464 subjects had an incident diagnosis of UC. 5\u2010 year cumulative incidence of elective colectomy reduced from 2.97% to 1.59%, and emergency colectomy from 3.90% to 2.67% from 2003\u20132007 to 2015\u20132020. For elective surgery, adjusted hazard ratio (aHR) 0.47 and for emergency surgery, aHR 0.60 when 2015\u20132020 was compared to 2003\u20132007. Colectomy was less likely in women (elective aHR 0.73, emergency aHR 0.71) and emergency colectomy was less likely in those aged 40\u201359, aHR 0.87 than in those aged 18\u201339. Ninety\u2010 day mortality for elective and emergency surgery was 1.47% and 3.81%, respectively. Use of advanced therapies increased from 2.53% to 16.71% at 5 years from diagnosis when comparing 2003\u20132007 and 2015\u20132020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Colectomy in the five years following diagnosis has declined, coinciding with an increased use of advanced therapies. Overall post\u2010operative mortality is low. While the indication for colectomy may influence the risk of adverse outcomes, aggregate data provide a reassuring picture of current practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70319","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T13:19:59Z","timestamp":1754659199000},"page":"119-131","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Temporal Trends in Medical and Surgical Management of Ulcerative Colitis in England: 2003\u20132020"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7940-2747","authenticated-orcid":false,"given":"J.","family":"Couch","sequence":"first","affiliation":[{"name":"National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre Nottingham University Hospitals and University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Thomas","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre Nottingham University Hospitals and University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2555-2250","authenticated-orcid":false,"given":"T. R.","family":"Card","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Centre Nottingham University Hospitals and University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7071-4098","authenticated-orcid":false,"given":"D. 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