Abstract
BACKGROUND AND AIM: Epidemiological data suggest a greater risk of inflammatory bowel disease in first- and second-generation migrants from a low to high prevalence country, with the risk of ulcerative colitis (UC) preceding Crohn's disease. This study evaluated demographic trends and outcomes of UC and acute severe ulcerative colitis (ASUC) hospitalizations in an area with an expanding multicultural population. METHODS: Demographic and disease characteristics of patients admitted with UC and ASUC at a tertiary metropolitan center from January 2016 to December 2024 were recorded. Trends in presentation and 12-month outcomes in ASUC patients of European and non-European descent were compared. RESULTS: Of 218 patient admissions with UC, 158 admissions met criteria for ASUC. A sixfold increase was seen in yearly admissions for UC (8 in 2016 to 48 in 2024) and ASUC (6 to 39, p < 0.001 for both). A total of 111 (50.9%) of patients hospitalized with UC, and 81 (51.2%) of patients with ASUC, were of European descent. Patients of non-European descent comprised an increasing proportion of hospitalized patients with UC (32.1% from 2016 to 2019 to 47.5% from 2020 to 2024, p = 0.047) and ASUC (not statistically significant: 28.9% to 51.0%, p = 0.076). No differences in disease severity, length of stay, 12-month readmission or colectomy rates were noted between European and non-European descent patients. CONCLUSIONS: A significant rise in hospitalizations for UC and ASUC, with an increasing proportion of patients with UC of non-European descent. There were no significant differences in clinical outcomes in ASUC admissions in patients of non-European descent compared to European descent.