S1788 Rates of Appropriate Management of Inpatients With Acute Severe Ulcerative Colitis

Introduction: At some stage of their disease, a considerable number of individuals with ulcerative colitis will develop a flare of acute severe ulcerative colitis (ASUC) requiring hospitalization. Due to the significant risk of complications with ASUC, it is imperative that medical providers follow best practice recommendations in order to optimize patient outcomes and quality of life. However, there is a notable gap in research exploring these measures. For this reason, adherence rates to guideline-based management should be examined to improve standardization of care and increase awareness. Methods: The single-center retrospective cohort study was conducted at a tertiary care center and received institutional review board approval. Patients admitted between 2014 and 2024 were included in the study as defined by Truelove and Witt’s criteria for ASUC. The primary outcome was the rate of venous thromboembolism (VTE) prophylaxis initiation. Secondary outcomes included rates of testing for Clostridioides difficile (C. diff) and cytomegalovirus (CMV), consultation with gastroenterology and colorectal surgery services, and clinical outcomes, including intravenous (IV) steroid failure, colectomy, 30-day readmission, and mortality for each admission. Patients under the age of 18 were excluded. Results: Out of 530 patient encounters reviewed, 35 patients met the inclusion criteria. These patients accounted for 56 hospital admissions, which included initial admissions and 30-day readmissions. The mean age of the cohort was 42.7 years, with 48% identifying as male. Among the 56 admissions, management and clinical outcome rates were calculated for VTE prophylaxis (43%), CMV testing (30%), C. diff (82%), gastroenterology consults (98%), colorectal surgery consults (30%), IV steroid failure (18%), colectomy (16%), 30-day readmission (23%), and mortality (0%). Conclusion: Our preliminary analysis revealed that patients who are admitted for ASUC are not all receiving the standard of care, specifically in terms of VTE prophylaxis and CMV testing, which are imperative. While the mortality rate in our cohort was 0%, our analysis indicates that there are opportunities for improvement, particularly in promoting the initiation of VTE prophylaxis as well as CMV testing. Further studies are needed to investigate how quality improvement intervention strategies can improve these measures and their impact on overall quality of care among patients with ulcerative colitis.