Title |
The use of a segmental endoscopic score may improve the prediction of clinical outcomes in acute severe ulcerative colitis.
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Published in |
Revista Española de Enfermedades Digestivas, January 2016
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DOI | 10.17235/reed.2016.4470/2016 |
Pubmed ID | |
Authors |
Samuel Raimundo Fernandes, Patrícia Santos, Carlos Miguel Moura, Pedro Marques da Costa, Joana Rita Carvalho, Ana Isabel Valente, Cilénia Baldaia, Ana Rita Gonçalves, Paula Moura Santos, Luís Araújo-Correia, José Velosa |
Abstract |
Acute severe colitis (ASC) remains a challenging complication of ulcerative colitis. The early identification of patients who will not respond to optimal therapy is warranted. Increasing evidence suggests that endoscopy may play a role in predicting important outcomes in acute severe colitis. The endoscopic activity of consecutive patients with acute severe colitis was evaluated using the Mayo endoscopic sub-score (Mayo) and the ulcerative colitis endoscopic index of severity (UCEIS). Two segmental indexes were also produced by summing the scores of the rectum and sigmoid (seg-Mayo and seg-UCEIS, respectively). Endpoints included the need for salvage therapy with infliximab or cyclosporine, refractoriness to corticosteroids, and colectomy. Of one hundred and eight patients enrolled in the study, 60 (55.6%) were male; with a median age of 34.5 years (range 15-80). All patients received intravenous steroids. Fifty-nine patients (55.6%) showed an incomplete or absent response to steroids, 35 patients (34.3%) received salvage therapy with infliximab or cyclosporine and 38 patients (33.3%) were colectomized during the index hospitalization or within the first year of follow-up. All scores were able to predict the need for surgery, but only the seg-UCEIS significantly predicted refractoriness to steroids. There was a strong correlation between endoscopic severity and unfavorable outcomes. The UCEIS outperformed the Mayo endoscopic sub-score in all important outcomes. Segmental scoring further improved the performance of the UCEIS. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 34 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 6 | 18% |
Researcher | 5 | 15% |
Student > Doctoral Student | 3 | 9% |
Other | 3 | 9% |
Student > Master | 2 | 6% |
Other | 3 | 9% |
Unknown | 12 | 35% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 16 | 47% |
Biochemistry, Genetics and Molecular Biology | 2 | 6% |
Computer Science | 2 | 6% |
Engineering | 1 | 3% |
Unknown | 13 | 38% |