Utility of Serum-Based Markers to Predict Severity, Histological Activity, and Rehospitalisation in Ulcerative Colitis

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Introduction: Inflammatory Bowel Disease (IBD) comprises ulcerative colitis (UC) and Crohn’s disease (CD). Serum-based non-invasive biomarkers are suggested for endoscopic and histological healing in clinical practice. Aims: The aim of this study was to investigate the utility of serum-based markers to predict severity, histological activity, and rehospitalization in ulcerative colitis. Materials and Methods: This was a cross-sectional study that was performed in a tertiary care center from October 2022 to March 2023. Diagnosis of ulcerative colitis on the basis of clinical history, imaging findings, flexible sigmoidoscopy/colonoscopy findings, and histopathology reports and agreed to participate were included. All the data, including blood parameters, were analysed. Results: C Reactive Protein (CRP)/albumin (AUC 0.821; 95% CI: 0.732 to 0.891, cut off point of >2.57), (AUC 0.875; 95% CI: 0.794 to 0.933, cut off point of >4.13) was the best predictor for correctly predicting endoscopic severity (UCEIS) and active histological inflammation and also a good predictor of re-hospitalization in the last 6 months (AUC 0.814; 95% CI: 0.724 to 0.885, cut off point of >6.34) as compared to red cell distribution width (RDW)/albumin (AUC 0.598; 95% CI: 0.495 to 0.695), (AUC 0.537; 95% CI: 0.434 to 0.637), which was non-significant. RDW/Albumin (AUC 0.793; 95% CI: 0.701 to 0.868) also predicts 6-month rehospitalization significantly but less as compared to CRP/Albumin. Conclusion: In ulcerative colitis, the CRP/ALB ratio was a strong predictor of endoscopic severity, histologic disease activity, and rehospitalization in 6 months. It can be used to predict treatment response and as an indirect biomarker for mucosal healing.