INTRODUCTION Limited guidance exists for the postdischarge care of patients with ulcerative colitis hospitalized for moderate-severe flares. METHODS RAND methodology was used to establish appropriateness of inpatient and postdischarge steroid dosing, discharge criteria, follow-up, and postdischarge biologic or small molecule initiation. A literature review informed on the panel's voting, which occurred anonymously during 2 rounds before and after a moderated virtual session. RESULTS Methylprednisolone 40-60 mg intravenous every 24 hours or hydrocortisone 100 mg intravenous 3 times daily is appropriate for inpatient management, with methylprednisolone 40 mg being appropriate if intolerant of higher doses. It is appropriate to discharge patients once rectal bleeding has resolved (Mayo subscore 0-1) and/or stool frequency has returned to baseline frequency and form (Mayo subscore 0-1). It is appropriate to discharge patients on 40 mg of prednisone after observing patients for 24 hours in hospital to ensure stability before discharge. For patients being discharged on steroids without in-hospital biologic or small molecule therapy initiation, it is appropriate to start antitumor necrosis factor (TNF) therapy after discharge for anti-TNF-naive patients. For anti-TNF-exposed patients, it is appropriate to start vedolizumab or ustekinumab for all patients and tofacitinib for those with a low risk of adverse events. It is appropriate to follow up patients clinically within 2 weeks and with lower endoscopy within 4-6 months after discharge. DISCUSSION We provide recommendations on the inpatient and postdischarge management of patients with ulcerative colitis hospitalized for moderate-severe flares.

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关于中重度溃疡性结肠炎入院期间和入院后合理使用类固醇和出院计划的建议：兰德公司适当性小组的结果。

引言 对于因中重度发作而住院的溃疡性结肠炎患者的出院后护理指导有限。方法兰德方法用于确定住院患者和出院后类固醇剂量、出院标准、随访以及出院后生物或小分子启动的适当性。文献综述对小组的投票提供了信息，投票在主持的虚拟会议之前和之后的两轮中以匿名方式进行。结果 甲基强的松龙 40-60 mg 每 24 小时静脉注射一次或氢化可的松 100 mg 静脉注射每日 3 次适合住院治疗，如果不能耐受更高剂量，则适合使用甲基强的松龙 40 mg。一旦直肠出血消失（Mayo 子评分 0-1）和/或大便频率恢复到基线频率和形式（Mayo 子评分 0-1），就可以让患者出院。住院观察24小时后，出院时宜服用40毫克泼尼松，确保出院前稳定。对于出院时使用类固醇但未开始院内生物或小分子治疗的患者，对于未接受过抗 TNF 治疗的患者，出院后最好开始抗肿瘤坏死因子 (TNF) 治疗。对于暴露于抗 TNF 药物的患者，适合所有患者开始使用维多珠单抗或乌特克单抗，而对于不良事件风险较低的患者开始使用托法替布。出院后2周内进行临床随访，4-6个月内进行下消化道内镜检查为宜。讨论 我们为因中重度发作而住院的溃疡性结肠炎患者的住院和出院后管理提供建议。