Patient selection: age >= 65 years with ulcerative colitis
Indications for surgery:
(1) ulcerative colitis refractory to medical management
(2) toxic megacolon
(3) dysplasia or carcinoma
Poor outcomes included:
(1) death
(2) complication that prolongs the hospitalization
(3) complication requiring a significant intervention
Predictors of a poor outcome:
(1) male gender
(2) low serum albumin (<= 2.8 g/dL)
(3) urgent or emergency surgery
Of these predictors, improving the serum albumin by nutritional support is the one modifiable factor.
NOTE: Considering the age of the population, other significant comorbid conditions would also be risk factors for a poor outcome.
