Ho, G.T.; Mowat, C.; Goddard, C.J.R.; Fennell, J.M.; Shah, N.B.; Prescott, R.P.; Satsangi, J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA69
Academic Journal
Backgrounds/Aims: The rate of failure of medical therapy in severe ulcerative colitis (UC) remains high (30-40%). We have identified predictor factors associated with poor outcome in patients presenting with severe attacks of UC and devised a numerical scoring system that categorises patients by risks. Methods: All patients admitted with severe UC (defined by the modified Truelove and Witts criteria) in three gastroenterology units in the Lothian region between January 1995 and March 2002. Fifty-six clinical and demographic parameters were analysed. Predictive factors were identified using multiple logistic regression and risk score was formulated using statistical modelling. Outcomes were categorised to non-responders (colectomy during hospitalisation) and responders. Results: Of 167 patients admitted, 68(40%) failed to respond to medical therapy. Mean stool frequency, albumin, and colonic dilatation within the first three days of treatment were identified as independent predictors of outcome. A numerical score was formulated using these variables (table 1). Patients with scores of 0-1, 2-3 and >4 had a rate of medical therapy failure of 12%, 43%, and 85% respectively. 42%, 34%, and 25% of patients fell into each respective category (table 1). Conclusion: Using this novel scoring system, we can clearly stratify patients to Iow, intermediate and high risk groups of non-response.


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