Abstract
Objectives:Ulcerative Colitis (UC) follows a natural clinical course of relapses and remissions. The aim of this study was to construct a risk-scoring formula in order to enable predicting relapses in patients with UC.Methods:From October 2012 to October 2013, 157 patients from Shiraz, southern Iran who were diagnosed with UC and in remission were enrolled. At 3-month intervals, multiple risk factors of hemoglobin, complete blood counts, serum iron and albumin, erythrocyte sedimentation rate, and faecal calprotectin levels, sex, age, cigarette smoking, positive family history of inflammatory bowel diseases, past history of appendectomy, extra-intestinal accompanying diseases, extent of disease at the beginning of study, number of previous relapses, duration of disease and duration of remission before the study were assessed. Univariate and multivariate logistic regression were applied to fit the final model. The new risk-scoring system accuracy was assessed using receiver-operating-characteristics (ROC) curve analysis.Results:Seventy four patients (48.1%) experienced a relapse. Multivariate analysis revealed that relapses could significantly be predicted by the level of fecal calprotectin (OR=8.1), age (OR=9.2), the Seo activity index (OR=52.7), and the number of previous relapses (OR=4.2). The risk scoring formula was developed using the regression coefficient values of the aforementioned variables.Conclusion:Four predictor variables were significant in the final model and were used in our risk-scoring formula. It is recommended that patients who achieve high scores are diligently observed, treated, and followed up.
Highlights
Inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative coloitis (UC), are the major gastrointestinal pathology, which have affected millions of people around the world
Multiple logistic regression analysis and final model: Multiple logistic regression analysis demonstrated four final independent variables: faecal calprotectin (FC), number of previous relapses (NPR), age, and Seo index were significantly associated with relapse
FC, NPR, age, and Seo index were included in the formula and it revealed significant predictive ability for prediction of relapse
Summary
Inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative coloitis (UC), are the major gastrointestinal pathology, which have affected millions of people around the world. Increased incidence of the diseases in the developing countries is demonstrated in recent reports.[1] The course of ulcerative colitis (UC) varies from decreased intestinal manifestations to extremely severe systemic signs and symptoms.[2] Prevalence of the recurrence of intestinal and systemic presentations in patients with UC is relatively high. Identifying patients at high risk of relapse and early onset of severe treatment (necessitating the use of early aggressive treatment) can prevent serious complications of the disease.[4] Obviously, the initiation of aggressive treatment in patients who do not need such treatment could lead to complications such as severe infections[5] or even carcinoma.[6] in order to prevent relapse and grave complications in patients with anticipated relapse it is critical to use clinical, demographic, or histological predictive factors.[7]
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