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

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

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.321 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S260-S262

Author(s):

A Mingazov ◽

S Achkasov ◽

A Vardanyan ◽

T Baranova

Keyword(s):

Ulcerative Colitis ◽

Predictive Value ◽

Logistic Model ◽

Metabolic Disorders ◽

Albumin Level ◽

Single Center ◽

C Reactive Protein ◽

Severe Ulcerative Colitis ◽

Reactive Protein ◽

Endoscopic Picture

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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