P195 Predictors of colectomy in patients with acute severe ulcerative colitis: single-center retrospective analysis

Abstract Background Acute severe ulcerative colitis is observed in 25% of patients1. Near 40% of this severe patients might undergo surgery2 and the mortality rate in this group of patients reaches 6.3%3. Untimely surgery leads to severe metabolic disorders, infectious postoperative complications, and increases the risk of death4,5. Eventually, the purpose of this study is identify predictors of colectomy in patients with acute severe ulcerative colitis. Methods A retrospective study included 74 patients with acute severe ulcerative colitis, who were treated at the clinic in 2017(Fig. 1). The patients were divided into the groups: group of colectomy - 54/74 (73%) and group of conservative treatment 20/74 (27%) (Fig 1). The predictors, like serum albumin, C-reactive protein, hemoglobin, endoscopic picture of «extensive ulcers», and clinical data were analyzed. The statistical analysis was performed using the software«Statistica 13.3» and «RStatistica». Results There were no difference by gender, age and duration of the disease in the groups. Mean of albumin and hemoglobin levels were significantly lower in the colectomy group. The endoscopy «extensive ulcers» was significantly more common in the operated patients (Tab 1). Also univariate, multivariate and ROC analyses were performed (Tab 2), (Fig 2). The risk of colectomy when endoscopy «extensive ulcers» combined with an albumin level<31 g/l and hemoglobin<107 g/l, was 100%. A nomogram for predicting the probability of colectomy was constructed (Fig 3). This logistic model has a statistically significantly high predictive value (AUC=0.93, p=0.006). Conclusion The endoscopic picture of «extensive ulcers» in combination with an albumin level of less than 31 g/l and hemoglobin less than 107 g/l are predictors of colectomy with high predictive value.

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PREDICTORS OF COLECTOMY IN PATIENTS WITH «EXTREMELY SEVERE» ULCERATIVE COLITIS

Koloproktologia ◽

10.33878/2073-7556-2020-19-3-37-48 ◽

2020 ◽

Vol 19 (3) ◽

pp. 37-48

Author(s):

S. I. Achkasov ◽

M. V. Shapina ◽

V. V. Veselov ◽

A. V. Vardanyan ◽

A. F. Mingazov ◽

...

Keyword(s):

Ulcerative Colitis ◽

Treatment Group ◽

Conservative Treatment ◽

Serum Albumin ◽

Predictive Value ◽

Albumin Level ◽

C Reactive Protein ◽

Severe Ulcerative Colitis ◽

Reactive Protein ◽

Endoscopic Picture

AIM: to identify predictors of colectomy in patients with «extremely severe» ulcerative colitis.PATIENTS AND METHODS: seventy-four patients with severe ulcerative colitis in 2017 were included in the study. The patients were divided into the groups of colectomy (54 pts) and conservative treatment (20 pts).The predictors such as serum albumin, C-reactive protein, hemoglobin, endoscopic picture, and clinical data were analyzed.RESULTS: the groups were homogeneous by gender, age and duration of the disease. Mean albumin and hemoglobin levels were significantly lower (28 g/l and 96 g/l) in the colectomy group.The endoscopic picture of «extensive ulcer defects merging among themselves» was significantly more common in the operated patients – 78%, compared with 5% in the conservative treatment group (p<0.0001). The risk of colectomy in the presence of an endoscopic picture was 85%, and when combined with an albumin level of less than 31 g/l and hemoglobin of less than 107 g/l, the risk increased to 100%.CONCLUSION: the endoscopic picture of «extensive, merging ulcerative defects» in combination with an albumin level of less than 31 g/l and hemoglobin less than 107 g/l are predictors of colectomy with high predictive value.

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C-reactive protein / albumin ratio is a good predictor of response to intravenous corticosteroids in acute severe ulcerative colitis

10.26226/morressier.59a6b34cd462b80290b55a1f ◽

2017 ◽

Author(s):

Sara Monteiro

Keyword(s):

Ulcerative Colitis ◽

Good Predictor ◽

C Reactive Protein ◽

Albumin Ratio ◽

Severe Ulcerative Colitis ◽

Reactive Protein

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Early Response to Corticosteroid and Baseline C-Reactive Protein Predicts Outcomes in Children with Moderate to Severe Ulcerative Colitis

Digestive Diseases and Sciences ◽

10.1007/s10620-019-05486-w ◽

2019 ◽

Vol 64 (7) ◽

pp. 1929-1937 ◽

Cited By ~ 1

Author(s):

Gayetri Deva Rajoo ◽

Lian Tan ◽

Ainslie Lopez ◽

Peter Lewindon ◽

Zubin Grover

Keyword(s):

Ulcerative Colitis ◽

Early Response ◽

C Reactive Protein ◽

Severe Ulcerative Colitis ◽

Reactive Protein

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Biomarker dynamics during infliximab salvage for acute severe ulcerative colitis: C-reactive protein (CRP)-lymphocyte ratio and CRP-albumin ratio are useful in predicting colectomy

Intestinal Research ◽

10.5217/ir.2020.00146 ◽

2021 ◽

Author(s):

Danny Con ◽

Bridgette Andrew ◽

Steven Nicolaides ◽

Daniel R van Langenberg ◽

Abhinav Vasudevan

Keyword(s):

Ulcerative Colitis ◽

C Reactive Protein ◽

Albumin Ratio ◽

Severe Ulcerative Colitis ◽

Lymphocyte Ratio ◽

Reactive Protein

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Su1827 - Markers of Systemic Inflammation in Moderate-Severe Ulcerative Colitis: What Level of C-Reactive Protein Constitutes Acute Severe Ulcerative Colitis?

Gastroenterology ◽

10.1016/s0016-5085(18)32173-5 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-598

Author(s):

Anthony Croft ◽

Anton Lord ◽

Graham L. Radford-Smith

Keyword(s):

Ulcerative Colitis ◽

Systemic Inflammation ◽

C Reactive Protein ◽

Severe Ulcerative Colitis ◽

Reactive Protein

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25-Hydroxycholecalciferol Concentration Is Associated with Protein Loss and Serum Albumin Level during the Acute Phase of Burn Injury

Nutrients ◽

10.3390/nu12092780 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2780

Author(s):

Andrzej Krajewski ◽

Krzysztof Piorun ◽

Dominika Maciejewska-Markiewicz ◽

Marta Markowska ◽

Karolina Skonieczna-Żydecka ◽

...

Keyword(s):

Vitamin D ◽

Protein Concentration ◽

Serum Albumin Level ◽

Burn Injury ◽

Albumin Level ◽

Albumin Concentration ◽

Transaminase Activity ◽

C Reactive Protein ◽

Reactive Protein ◽

25 Hydroxycholecalciferol

Background: Burned patients have an increased need for vitamin D supply related to the maintenance of calcium–phosphate homeostasis and the regulation of cell proliferation/differentiation. This study aimed to analyze the concentration of 25-hydroxycholecalciferol and its relationship with severe condition after burn injury. Methods: 126 patients were enrolled in the study. Patients were qualified due to thermal burns—over 10% of total body surface area. On the day of admission, the following parameters were assessed: 25-hydroxycholecalciferol concentration, total protein concentration, albumin concentration, aspartate transaminase activity, alanine transaminase activity, albumin concentration, creatinine concentration, c-reactive protein concentration, procalcitonin concentration, and interleukin-6 concentration. Results: Almost all patients (92%) in the study group had an improper level of vitamin D (<30 ng/mL), with the average of 11.6 ± 10.7 ng/mL; 17.5% of patients had levels of vitamin D below the limit of determination—under 3 ng/mL. The study showed that there are several factors which correlated with vitamin D concentration during the acute phase of burn injury, including: total protein (r = 0.42, p < 0.01), albumin, (r = 0.62, p < 0.01), percentage of body burns (r = 0.36, p < 0.05), aspartate aminotransferase (r = 0.21, p < 0.05), and c-reactive protein (r = 0.22, p < 0.05). We did not find any significant correlation between vitamin D concentration and body mass index. Conclusions: The burn injury has an enormous impact on the metabolism and the risk factors of the deficiency for the general population (BMI) have an effect on burned patients. Our study showed that concentration of 25-hydroxycholecalciferol is strongly correlated with serum albumin level, even more than total burn surface area and burn degrees as expected. We suspect that increased supplementation of vitamin D should be based on albumin level and last until albumin levels are balanced.

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Predictive value of C-reactive protein for radiographic spinal progression in axial spondyloarthritis in dependence on genetic determinants of fibrin clot formation and fibrinolysis

RMD Open ◽

10.1136/rmdopen-2021-001751 ◽

2021 ◽

Vol 7 (2) ◽

pp. e001751

Author(s):

Berthold Hoppe ◽

Christian Schwedler ◽

Hildrun Haibel ◽

Maryna Verba ◽

Fabian Proft ◽

...

Keyword(s):

Predictive Value ◽

Axial Spondyloarthritis ◽

Fibrin Clot ◽

Clot Formation ◽

Genetic Determinants ◽

C Reactive Protein ◽

Inception Cohort ◽

Reactive Protein ◽

A Subunit ◽

Fibrin Clots

ObjectiveGenetic determinants of fibrin clot formation and fibrinolysis have an impact on local and systemic inflammatory response. The aim of the present study was to assess whether coagulation-related genotypes affect the predictive value of C-reactive protein (CRP) in regards of radiographic spinal progression in axial spondyloarthritis (axSpA).MethodsTwo hundred and eight patients with axSpA from the German Spondyloarthritis Inception Cohort were characterised for genotypes of α-fibrinogen, β-fibrinogen (FGB) and γ-fibrinogen, factor XIII A-subunit (F13A) and α2-antiplasmin (A2AP). The relation between CRP levels and radiographic spinal progression defined as worsening of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) by ≥2 points over 2 years was assessed in dependence on the respective genetic background in logistic regression analyses.ResultsOverall, CRP was associated with mSASSS progression ≥2 points: time-averaged CRP ≥10 mg/L, OR: 3.32, 95% CI 1.35 to 8.13. After stratification for coagulation-related genotypes, CRP was strongly associated with mSASSS progression in individuals predisposed to form loose, fibrinolysis-susceptible fibrin clots (FGB rs1800790GG, OR: 6.86, 95% CI 2.08 to 22.6; A2AP 6Trp, OR: 5.86, 95% CI 1.63 to 21.0; F13A 34Leu, OR: 8.72, 95% CI 1.69 to 45.1), while in genotypes predisposing to stable fibrin clots, the association was absent or weak (FGB rs1800790A, OR: 0.83, 95% CI 0.14 to 4.84; A2AP 6Arg/Arg, OR: 1.47, 95% CI 0.35 to 6.19; F13A 34Val/Val, OR: 1.72, 95% CI 0.52 to 5.71).ConclusionsElevated CRP levels seem to be clearly associated with radiographic spinal progression only if patients are predisposed for loose fibrin clots with high susceptibility to fibrinolysis.

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Clinical characteristics and risk factors for mortality in COVID-19 inpatients in Birjand, Iran: a single-center retrospective study

European Journal of Medical Research ◽

10.1186/s40001-021-00553-3 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Ghodsiyeh Azarkar ◽

Freshteh Osmani

Keyword(s):

Risk Factors ◽

Platelet Count ◽

Protein Level ◽

Clinical Characteristics ◽

Single Center ◽

C Reactive Protein ◽

Reactive Protein ◽

Risk Of Death ◽

Survivor Group ◽

Epidemiological Characteristics

Abstract Background The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment. Methods This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses. Results The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases. Conclusions Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.

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Fecal Calprotectin, CRP and Leucocytes in IBD Patients: Comparison of Biomarkers With Biopsy Results

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwaa009 ◽

2020 ◽

Author(s):

Barry D Kyle ◽

Terence A Agbor ◽

Shajib Sharif ◽

Usha Chauhan ◽

John Marshall ◽

...

Keyword(s):

Ulcerative Colitis ◽

Fecal Calprotectin ◽

Dependent Manner ◽

Ascending Colon ◽

C Reactive Protein ◽

Concentration Dependent Manner ◽

Reactive Protein ◽

Inflammatory Bowel ◽

Descending Colon ◽

Active Inflammation

Abstract Background This study aimed to compare fecal calprotectin (FC) levels with other commonly used parameters as part of patient care during evaluation for inflammatory bowel disease (IBD). Methods We recruited adult IBD patients with ulcerative colitis (UC) and Crohn’s disease (CD) and compared the results of the patient’s biopsy results (i.e., inflamed versus noninflamed) for six sites (i.e., ileum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum) with concentrations of C-reactive protein (CRP), total leucocytes and fecal calprotectin (FC). Results We found that FC was significantly elevated in a concentration-dependent manner that correlated with the number of active inflammation sites reported in biopsy. Although CRP and leucocyte measurements trended upwards in line with inflammation reported from biopsy, the results were highly variable and highlighted poor reliability of these biomarkers for indicating IBD inflammation. Conclusions These results strongly suggest that FC correlates best with biopsy reports and is a superior marker than CRP and leucocytes.

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