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The use of a segmental endoscopic score may improve the prediction of clinical outcomes in acute severe ulcerative colitis
Fernandes, Samuel Raimundo; Santos, Patricia M; Moura, Carlos Miguel; Marques da Costa, Pedro; Carvalho, Joana Rita; Valente, Ana Isabel; Baldaia, Cilénia; Rita Gonçalves, Ana; Moura Santos, Paula; Araújo-Correia , Luís; Velosa, José.
Afiliação
  • Fernandes, Samuel Raimundo; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Santos, Patricia M; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Moura, Carlos Miguel; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Marques da Costa, Pedro; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Carvalho, Joana Rita; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Valente, Ana Isabel; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Baldaia, Cilénia; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Rita Gonçalves, Ana; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Moura Santos, Paula; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Araújo-Correia , Luís; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
  • Velosa, José; Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Department of Gastroenterology and Hepatology. Lisboa. Portugal
Rev. esp. enferm. dig ; 108(11): 697-702, nov. 2016. tab, graf
Article em En | IBECS | ID: ibc-157560
Biblioteca responsável: ES1.1
Localização: BNCS
ABSTRACT
Background: 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. Methods: 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. Results: 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 ndex 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. Conclusions: 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 (AU)
RESUMEN
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Assuntos

Texto completo: 1 Coleções: 06-national / ES Base de dados: IBECS Assunto principal: Prognóstico / Colite Ulcerativa / Corticosteroides / Endoscopia Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: En Revista: Rev. esp. enferm. dig Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Coleções: 06-national / ES Base de dados: IBECS Assunto principal: Prognóstico / Colite Ulcerativa / Corticosteroides / Endoscopia Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: En Revista: Rev. esp. enferm. dig Ano de publicação: 2016 Tipo de documento: Article