Development and validation of a composite score to predict severe forms of ischemic colitis.
Eur Radiol
; 32(9): 6355-6366, 2022 Sep.
Article
em En
| MEDLINE
| ID: mdl-35353197
ABSTRACT
OBJECTIVE:
To develop a simple scoring system in order to predict the risk of severe (death and/or surgery) ischemic colitisMETHODS:
In this retrospective study, 205 patients diagnosed with ischemic colitis in a tertiary hospital were consecutively included over a 6-year period. The study sample was sequentially divided into a training cohort (n = 103) and a validation cohort (n = 102). In the training cohort, multivariable analysis was used to identify clinical, biological, and CT variables associated with poor outcome and to build a risk scoring system. The discriminative ability of the score (sensitivity, specificity, positive predictive value, negative predictive value) was estimated in the two cohorts to externally validate the score, and a receiver operating characteristic curve was established to estimate the area under the curve of the score. Bootstrapping was used to validate the score internally.RESULTS:
In the training cohort, four independent variables were associated with unfavorableoutcome:
hemodynamic instability (2 pts), involvement of the small bowel (1 pt), paper-thin wall pattern (3 pts), no stratified enhancement pattern (1 pt). The score was used to categorize patients into low risk (score 0, 1), high risk (score 2-3), and very high risk (score 4-7) groups with sensitivity and specificity of 97% and 67%, respectively, and a good discriminating capability, with a C-statistic of 0.94. Internal and external validation showed good discrimination capability (C-statistics of 0.9 and 0.84, respectively).CONCLUSION:
A simple risk score can stratify patients into three distinct prognosis groups, which can optimize patient management. CLINICAL TRIAL NUMBER NCT04662268 KEY POINTS ⢠Simple scoring system predicting the risk of severe ischemic colitis ⢠First study to include CT findings to the clinical and biological data used to determine a severity score.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Colite Isquêmica
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
França