A Case of Bilateral Acute Inferior Limb Ischemia in a Patient With Ulcerative Colitis

A patient was diagnosed with ulcerative colitis (UC) in 2010. In March 2015, she had abdominal pain, diarrhea, bloody stool, and UC has relapsed. In June 2015, pain and sensory disturbance of both lower limbs appeared. Blood flow at the distal femoral artery was not confirmed with magnetic resonance angiography, and it was diagnosed as bilateral acute inferior limb ischemia. Arterial thrombolectomy with Fogarty’s balloon catheter was performed and blood flow was improved. The severity of UC was moderate with Mayo score 8. Thrombosis is considered to be a complication with a high incidence in inflammatory bowel disease. Reports of arterial thrombosis are very rare. It is important to evaluate the risk of bleeding and thrombosis in active or severe cases in UC and need to do thrombotic prophylactic treatment simultaneously with UC treatment.

Download Full-text

Analysis of associated diseases in patients with acute critical lower limb ischemia

Medicinski pregled ◽

10.2298/mpns1302041m ◽

2013 ◽

Vol 66 (1-2) ◽

pp. 41-45 ◽

Cited By ~ 10

Author(s):

Vladimir Manojlovic ◽

Vladan Popovic ◽

Dragan Nikolic ◽

Djordje Milosevic ◽

Janko Pasternak ◽

...

Keyword(s):

Mortality Rate ◽

Lower Limb ◽

Balloon Catheter ◽

Limb Ischemia ◽

Lower Limbs ◽

Metabolic Decompensation ◽

Arterial Embolism ◽

Lower Limb Ischemia ◽

Associated Diseases ◽

Arterial Blood

Introduction. Acute critical lower limb ischemia refers to the state of severely impaired vitality of lower limbs due to acute occlusion of arterial blood vessel by a thrombus or emboli. Surgical revascularization in the first 6-12 hours after the onset of symptoms gives the best results. However, a high mortality rate and probability of limb loss make this problem more debatable, and can be related with associated diseases. Material and Methods. This research included 95 patients who had been operated within the first 12 hours after the onset of symptoms of critical limb ischemia. We collected the following data: age and sex of patients, etiology of limb ischemia, type of operation, associated diseases and outcome of treatment. Results and Discussion. Most of the patients were 70 to 80 years old, both sexes being equally represented. There was significantly more arterial embolism (70%) than thrombosis on the prior arterial lesion. Most of the embolizations were treated with Fogarty balloon catheter embolectomy (98%); however, a great number of arterial thrombosis demanded more complex ?inflow? and ?outflow? ensuring procedures such as thromboendarterectomy and bypass (33%). The performed surgical procedures showed no statistical differences when final outcome was analyzed. Amputation had to be performed in about 3% of the patients and all of them were diabetics. Mortality rate in this research was 10.5% and 7/10 with this outcome had severe form of chronic myocardiopathy and metabolic decompensation. Conclusion. Acute critical lower limb ischemia should be treated surgically as soon as possible. Negative outcomes are associated with comorbidity and general condition of the patient.

Download Full-text

P284 Drug survival and remission rates in ustekinumab treated ulcerative colitis: Results from the Swedish Inflammatory Bowel Disease register (SWIBREG)

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.409 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S317-S317

Author(s):

J Thunberg ◽

O Björkqvist ◽

O Olén ◽

J F Ludvigsson ◽

C Eriksson ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Clinical Effectiveness ◽

Continuation Rate ◽

Mayo Score ◽

Disease Register ◽

Remission Rates ◽

Inflammatory Bowel ◽

Biochemical Remission

Abstract Background Randomised controlled trials may not correctly reflect clinical practice. We aimed to assess the clinical effectiveness of ustekinumab in a real-world cohort of patients with ulcerative colitis (UC). Methods This observational, multi-centre cohort study explored ustekinumab treated patients with UC from the Swedish inflammatory bowel disease register (SWIBREG), a nationwide quality register. Prospectively collected clinical data were extracted December 2020. The primary outcome was the 16-week ustekinumab continuation rate. Secondary outcomes included A) drug continuation rate at the end of follow-up, B) corticosteroid-free biochemical remission, defined as f-Calprotectin<250µg/g, and C) corticosteroid-free clinical remission per patient-reported Mayo score, i.e. a rectal bleeding subscore <1 and a stool frequency subscore ≤1 and not greater than baseline. Continuous data are presented as median and (interquartile range). Differences between baseline and follow-up visits were assessed by the Wilcoxon signed-rank test. Results In total, 145 patients were included and followed for a median period of 32 (19-56) weeks. Baseline characteristics are presented in Table 1. The drug continuation rate was 87% (126/145) at 16 weeks and 69% (100/145) at end of follow-up (Figure 1-2). Corticosteroid-free clinical and biochemical remission rates at follow-up visits are shown in Figure 3. The 6-point Mayo score decreased from 5 (3-6) at baseline to 2 (2-4) at 16 weeks (p<0.01) and to 3 (2-4) at last follow-up (p<0.01). F-calprotectin levels decreased from 779 (252-1530) µg/g to 246 (56-844) µg/g at week 16 (p=0.02) and to 142 (36-935) µg/g at last follow-up (p<0.01). Conclusion Ustekinumab was associated with clinical effectiveness in this nationwide real-world treatment refractory cohort.

Download Full-text

P526 Social functioning, work-productivity and psychological assessment in a cohort of patients with inflammatory bowel disease: an observational study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.648 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S501-S503

Author(s):

A Todeschini

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Observational Study ◽

Social Functioning ◽

Trait Anxiety ◽

Psychological Assessment ◽

Work Productivity ◽

Level Of Education ◽

Mayo Score ◽

Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn’s disease, claims to suffer a significant hindrance in everyday life, because of the frequency of psychological complaints. The aim of this study was to identify and analyze social functioning, work productivity and psychological assessment in IBD patients and to correlate these parameters with history and activity of the disease. Methods An observational study was performed in 99 IBD patients. Psychosocial data were assessed through the administration of specific questionnaires: Social Functioning Questionnaire (QFS) for monitoring social functioning; Work Productivity and Activity Impairment questionnaire (WPAI) for work productivity; State-Trait Anxiety Inventory (STAI 1,2), for psychological assessment. IBD activity was measured by Partial Mayo score. Student’s t test or Wilcoxon rank sum test were used to compare continuous variables between subgroups and chi-square test to compare categorical variables. Univariate and multivariate linear regression were used, respectively, to assess the relationship between psychosocial and disease characteristics and to compare outcomes with determinant associated results in univariate regression. Results Univariate analysis showed a statistically significant correlation of the overall QFS score with both the level of education (0.6; 95% CI = 0.1–1.2; p = 0.028) and the unemployed status (- 4.5; 95% CI = -8.9- -0.1; p = 0.044). Moreover, the impairment of WPAI was greater in subjects with ulcerative colitis with severe endoscopic activity according with Partial Mayo score (15.5; 95% CI = 1.0–30.0; p = 0.038). Overall impairment in subjects with stable employment correlated with age (- 0.5; 95% CI = -0.9- -0.1; p = 0.010) and was greater in subjects who underwent at least one surgical operation (15.8; 95% CI = 3.0–28.6; p = 0.016). Psychological evaluation showed that state and trait anxiety correlated significantly with Partial Mayo score (respectively 1.8; 95% CI = 0.6–2.7; p = 0.004 and 1.3; 95% CI = 0.1–2.5; p = 0.042) and age (respectively - 0.2; 95% CI = -0.3- -0.1; p = 0.028 and - 0.3; 95% CI = -0.5 - -0.1; p = 0.037). State anxiety increased in case of long-standing illness (- 0.3; 95% CI = -0.5 - -0.1; p = 0.037), while the non-worker status correlated with trait anxiety when compared to paid employment (- 7.0; 95% CI = -0.9–13.1; p = 0.026). Conclusion Social functioning was correlated to the employment status and to the level of education. Work productivity was lower in UC patients with severe activity and who undergone at least one surgery related to IBD. The state of anxiety was related with age, duration and activity of illness, while the trait of anxiety was major in non-worker patients.

Download Full-text

P077 A NEW TREATMENT APPROACH FOR INFLAMMATORY BOWEL DISEASE: INTRACOLONIC BIFIDOBACTERIUM AND XYLOGLUCAN APPLICATION

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.090 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S35-S36

Author(s):

Hüseyin Bozkurt

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Mucosal Healing ◽

Single Administration ◽

Diagnostic Strategies ◽

Bifidobacterium Animalis ◽

Mayo Score ◽

Before And After ◽

Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) pathogenesis includes the altered gut microbiota, environmental factors, human immune responses and genetic. Reduced bifidobacteria level is associated with IBD. Xyloglucan is a plant based prebiotic oligosaccharide. Bifidobacteria level is increased in the presence of xyloglucan. In this article we aim to share the results of our cases; Ulcerative colitis (UC) patients treated by intracolonic single administration of Bifidobacterium animalis subsp. lactis and Xyloglucan combination. Methods Ten UC patients were evaluated; before and after intracolonic single administration of Bifidobacterium animalis subsp. lactis and Xyloglucan combination with colonoscopic laboratory and clinical examination. Results Age, sex, diagnosis, disease location, previous medications are summarized in Table 1. All the patients had active ulcerative colitis disease before the administration. The Mayo Score was used to assess the severity of UC. 2 cases had extensive colitis and 8 patients had left-sided colitis. After 6 weeks of the administration mucosal healing and resolution of colonic symptoms were seen. These results are summarized in Table 2. Of the 10 cases, 7 were undertaken 5-ASA +Azathiopurine and three were undertaken vedolizumab treatment. Intracolonic single Bifidobacterium animalis subsp. lactis and xyloglucan administration was found effective in the mucosal healing and resolution of colonic symptoms in ulcerative colitis patients. Conclusions Herein we reported the importance of Bifidobacterium and xylooligosaccharide combination in IBD. Colonoscopic single Bifidobacterium animalis subsp. lactis and xyloglucan administration is a new method that has no side effect and easy to apply for treatment of IBD.This application might provide enhancement of non-stimulatory status and higher biodiversity in colonic mucosa so mucosal healing may be improved rapidly. However, it would be necessary to develop diagnostic strategies in order to discriminate which patients would benefit from this strategy.

Download Full-text

“Silent” thrombosis of an abdominal aortic aneurysm not producing acute limb ischemia

VASA ◽

10.1024/0301-1526/a000040 ◽

2010 ◽

Vol 39 (3) ◽

pp. 265-267 ◽

Cited By ~ 2

Author(s):

Moulakakis ◽

Maras ◽

Bountouris ◽

Pomoni ◽

Georgakis ◽

...

Keyword(s):

Blood Flow ◽

Abdominal Aortic Aneurysm ◽

Mortality Rate ◽

Aortic Aneurysm ◽

Acute Pain ◽

Limb Ischemia ◽

Lower Limbs ◽

Acute Limb Ischemia ◽

Abdominal Aortic ◽

Flow Through

Thrombosis of an abdominal aortic aneurysm is a rare devastating complication with an estimated mortality rate of 50%. Simultaneous acute pain, pallor and coldness of the lower limbs, mottling from the level of iliac crests or umbilicus, paraplegia and absence of femoral pulses are all manifestations of a sudden and acute interruption of blood flow through the aneurysmatic aorta. We report a case of an occlusion of an abdominal aortic aneurysm during hospitalization which was not manifested with symptoms of limb ischemia. In this case we feature the rare and unusually “silent” presentation of the event.

Download Full-text

P690 A propensity score weighted comparison of vedolizumab, adalimumab, and golimumab in patients with ulcerative colitis: Real-life data from the Sicilian Network for Inflammatory Bowel Disease (SN-IBD)

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.818 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S561-S562

Author(s):

F S Macaluso ◽

M Ventimiglia ◽

W Fries ◽

A Viola ◽

M Cappello ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Propensity Score ◽

Clinical Benefit ◽

Real Life ◽

Mucosal Healing ◽

Treatment Persistence ◽

Mayo Score ◽

Inflammatory Bowel

Abstract Background No real-life study aiming at comparing at the same time the effectiveness of vedolizumab (VDZ), adalimumab (ADA), and golimumab (GOL) in Ulcerative colitis (UC) is currently available. Methods Data of consecutive patients with UC treated with VDZ, ADA, and GOL from June 2015 to December 2018 were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Disease (SN-IBD). A three-arms propensity score-adjusted analysis was performed to reduce bias caused by imbalanced covariates at baseline, including the proportion of TNF-α inhibitor naïve and non-naïve patients, using the Inverse Probability of Treatment Weighting (IPTW) method. The effectiveness was evaluated at 8 weeks, 52 weeks, and as treatment persistence at the end of follow-up. The clinical endpoints were steroid-free clinical remission (partial Mayo score <2 without steroid use) and clinical response (reduction of the partial Mayo score ≥2 points with a concomitant decrease of steroid dosage compared with baseline). The sum of the two outcomes was defined as a clinical benefit. The achievement of mucosal healing (endoscopic Mayo score 0–1) was assessed after at least 6 months of biological treatment. Results A total of 463 treatments (VDZ: n = 187; ADA: n = 168; GOL: n = 108) were included, with a median follow-up of 47.6 weeks (IQR 20.0–85.9). At 8 weeks, a clinical benefit was achieved in 70.6% patients treated with VDZ, in 68.5% patients treated with ADA, and in 67.6% patients treated with GOL (p = n.s. for all comparisons). After 52 weeks, VDZ showed better rates of clinical benefit compared with both ADA (71.6% vs. 47.5; OR: 2.79, 95% CI 1.63–4.79, p < 0.001) and GOL (71.6% vs. 40.2%; OR: 3.77, 95% CI 2.08–6.80, p < 0.001), while the difference between ADA and GOL was not significant. Cox survival analysis demonstrated that patients treated with VDZ had a reduced probability of treatment discontinuation compared with those treated with ADA (HR: 0.42, 95% CI 0.28–0.64, p < 0.001) and GOL (HR: 0.30, 95% CI 0.19–0.46, p < 0.001), while patients treated with ADA had a reduced risk of treatment discontinuation compared with those treated with GOL (HR: 0.71, 95% CI 0.50–1.00, p = 0.048). Post-treatment mucosal healing rates showed a numerical but non-significant difference in favour of VDZ (48.1%) compared with ADA and GOL (38.0% and 34.6%, respectively). Conclusion In the first study comparing at the same time the clinical effectiveness of VDZ, ADA, and GOL in UC patients via propensity score-adjusted analysis, VDZ was superior to both subcutaneous agents at 52 weeks and as treatment persistence, while ADA showed a superior treatment persistence compared with GOL.

Download Full-text

Treatment Targets in Inflammatory Bowel Disease: Current Status in Daily Practice

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.254.ken ◽

2016 ◽

Vol 25 (4) ◽

pp. 465-471 ◽

Cited By ~ 8

Author(s):

Tessa E.H. Römkens ◽

Kim Gijsbers ◽

Wietske Kievit ◽

Frank Hoentjen ◽

Joost P.H. Drenth

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Normal Mucosa ◽

Mucosal Healing ◽

Treatment Targets ◽

Mayo Score ◽

Inflammatory Bowel

Background & Aims: Recently, treatment goals in inflammatory bowel disease (IBD) in clinical trials have shifted from mainly symptom-based to more mucosa-driven. Real world data on treatment priorities are lacking. We aimed to investigate the current practice and most commonly used definitions of IBD treatment targets among Dutch gastroenterologists. Methods: Dutch gastroenterologists were asked to participate in a computer-based nation-wide survey. We asked questions on demographics, opinion and current practice regarding IBD treatment targets. Results: Twenty-four percent (134/556) of the respondents completed the survey. For both Crohn’s disease (CD) (47.3%, 61/129) and ulcerative colitis (UC)(45%, 58/129) the main treatment goal was to achieve and maintain deep remission, defined as clinical, biochemical and endoscopic remission. Seventy-six percent of the participants use mucosal healing (MH) as a potential treatment target for IBD, whereas 22.6% use histological remission. There is no single definition for MH in IBD. The majority use Mayo score ≤ 1 in UC (52%) and ‘macroscopic normal mucosa’ in CD (66%). Conclusion: More stringent and mucosa-driven treatment targets as ‘deep remission’ and ‘mucosal healing’ have found traction in clinical practice. The most commonly used definition for MH in routine practice is endoscopic MAYO score ≤ 1 in UC and ‘macroscopic normal mucosa’ in CD. Abbreviations: CD: Crohn’s disease; CDEIS: Crohn‘s Disease Endoscopic Index of Severity; IBD: Inflammatory Bowel Disease; IBDU: IBD unclassified; IOIBD: International Organization for the Study of Inflammatory Bowel Diseases; MH: Mucosal healing; MMH: Microscopic mucosal healing; PROMS: Patient reported outcome measures; SES-CD: Simple endoscopic score for Crohn’s disease; UC: ulcerative colitis; UCEIS: Ulcerative Colitis Endoscopic Index of Severity.

Download Full-text

Case of persistent sciatic artery in a dialysis patient with critical limb ischemia

SAGE Open Medical Case Reports ◽

10.1177/2050313x211068554 ◽

2022 ◽

Vol 10 ◽

pp. 2050313X2110685

Author(s):

Yasuhito Nakamura ◽

Yoshitaka Kumada ◽

Akihiro Mori ◽

Norikazu Kawai ◽

Narihiro Ishida

Keyword(s):

Blood Flow ◽

Saphenous Vein Graft ◽

Limb Ischemia ◽

Lower Limbs ◽

Whole Body ◽

Persistent Sciatic Artery ◽

Stenotic Lesion ◽

Contrast Enhanced ◽

Pain At Rest ◽

Enhanced Computed Tomography

Persistent sciatic artery is a rare congenital malformation (incidence rate, 0.03%–0.06%). We report the case of a 72-year-old male patient with persistent sciatic artery suffering from pain at rest and an ulcer on the left first toe. Angiography findings showed 90% stenosis in the distal persistent sciatic artery. Endovascular therapy was considered difficult because of a long stenotic lesion from the persistent sciatic artery to the popliteal artery and extremely high calcification of the whole body. Because of poor blood flow to the lower leg, vascular prosthesis would have increased the risk of thrombotic occlusion. Therefore, below-knee femoropopliteal bypass using the great saphenous vein graft was performed, which led to the healing of the ulcer on the left first toe. Contrast-enhanced computed tomography of the lower limbs was performed to confirm that the bypass blood flow was good. The patient was discharged on postoperative day 5.

Download Full-text

P461 Vedolizumab Dose Escalation in a Real-World Cohort of IBD Patients

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.584 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S454-S454

Author(s):

Z Zelinkova ◽

B Kadleckova ◽

J Lucenicova

Keyword(s):

Ulcerative Colitis ◽

Dose Escalation ◽

Dose Regimen ◽

Pharmacokinetic Profile ◽

Secondary Loss ◽

Loss Of Response ◽

Mayo Score ◽

Conventional Regimen ◽

Inflammatory Bowel ◽

Local Protocol

Abstract Background Vedolizumab (VDZ) effectively induces and maintains remission in inflammatory bowel disease (IBD). The loss of response to VDZ has been shown to be recaptured with dose escalation but the data in this field are still scarce. In addition, data on pharmacokinetics (PK) of dose escalation are limited and it is unclear whether PK should used in decision-making algorithm in adjusting VDZ dose regimen. Therefore, the aim of our study was to assess clinical efficacy and pharmacokinetic profile of VDZ dose escalation. Methods All IBD patients treated with VDZ in one tertiary IBD centre were retrospectively retrieved from the database. According to local protocol, non-responders to standard dosing of 300 mg i.v. of VDZ every 8 weeks, received escalated dose of 300mg i.v. every 6 or 4 weeks. Disease activity was assessed by Harvey-Bradshaw index (HBI) and partial Mayo score in Crohn’s disease (CD) and ulcerative colitis (UC) pts; respectively. VDZ dose was escalated in case of clinically assessed primary non response by week 22 of the treatment or in case of secondary loss of response. Response to dose escalation was defined as a decrease of HBI of ≥2 points, partial Mayo score ≥3 points or endoscopic improvement. VDZ through levels were assessed at the completion of induction and in dose escalated patients after at least two VDZ administrations in shortened interval. Results In total, 75 IBD patients were included (mean age 47 years, range 20–90; 36 men; 35 CD/39UC/1 IBD-U). Fifty two pts (69%) were primary responders, out of these 23 pts (44%) required dose escalation at some point of the treatment due to secondary loss of response. Out of 23 primary non-responders, 10 stopped the treatment, the remaining 13 received escalated dose of VDZ. Altogether, dose escalation was used in 36 pts (48%). There were no differences in the proportion of CD and UC between conventional and escalated dose regimen groups. Among secondary loss of response, the response was recaptured in 15 out of 23 pts (65%} while only two out of thirteen primary non-responders responded to dose escalation. There were no significant differences in VDZ levels between pts requiring dose escalation and pts with stable response to conventional regimen (mean levels 9,97±1,276 vs. 12,79±1,771 µg/mL; p=n.s.). VDZ levels increased significantly in patients who responded to dose escalation (from 10,12±3,460 to 20,81±3,326 µg/mL; p=0.0497). Conclusion Response to vedolizumab can be successfully recaptured in two thirds of secondary non responders by dose escalation. Patients requiring dose escalation do not seem to differ from stable responders with regards to vedolizumab pharmacokinetics.

Download Full-text

N08 Construction of an explanatory model for quality of life in outpatients with ulcerative colitis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab074.822 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S612-S612

Author(s):

M Takahashi ◽

M Nunotani ◽

N Aoyama

Keyword(s):

Quality Of Life ◽

Ulcerative Colitis ◽

Psychological Symptoms ◽

Explanatory Model ◽

Explanatory Variables ◽

Treatment Side Effects ◽

Mayo Score ◽

Inflammatory Bowel ◽

The Relationship

Abstract Background Previous studies have reported explanatory models of health-related quality of life (HRQoL) in patients with Crohn disease or inflammatory bowel disease. However, no model for HRQoL has been developed that is specialised for patients with ulcerative colitis (UC). In this study, we aimed to develop and evaluate a predictive explanatory model for HRQoL among outpatients with UC in Japan. Methods We conducted a cross-sectional survey between December 2019 and July 2020 at a clinic in Japan. HRQoL was evaluated using the 32-item Inflammatory Bowel Disease Questionnaire (IBDQ-32). We extracted explanatory variables of HRQoL, including disease activity, psychological symptoms, and social support, from previous studies and created an explanatory model based on the conceptual model of Wilson & Cleary (1995). The relationship between explanatory variables and the IBDQ-32 total score was examined using the Spearman’s rank correlation coefficient, Mann–Whitney test, or Kruskal–Wallis test. We conducted multiple regression analysis and path analysis to examine the effect of explanatory variables on IBDQ-32 total score. Results We included a total of 203 patients with UC. Variables that were significantly associated with the IBDQ-32 total score were partial Mayo Score, presence or absence of treatment side effects, Hospital Anxiety and Depression Scale (HADS) score, and having/not having an adviser when patients were severely ill-conditioned. HADS had the largest negative effect on IBDQ-32 total score (β = −0.474), followed by partial Mayo Score (β = −0.408), presence/absence of treatment side effects (β = −0.116), having/not having an adviser when patients were ill-conditioned (β = 0.081). Having an adviser or not when ill-conditioned had an indirect effect on patients’ IBDQ-32 total score via HADS (β = −0.111). We verified the final model, which included IBDQ-32 total score and the above four explanatory variables (adjusted R² = 0.501, GFI = 0.996, AGFI = 0.970, CFI = 1.000, RMSEA = 0.010, AIC = 28.043). Conclusion Psychological symptoms had the most direct effect on HRQoL in patients with UC and acted as a mediator in the relationship between social support and HRQoL. Nursing interventions to improve HRQoL in patients with UC should consider the effect of psychological symptoms and support when patients are severely ill-conditioned.

Download Full-text