The Degree of Ulcerative Colitis Burden of Luminal Inflammation score is superior to predicting medium- to long-term prognosis in patients with active ulcerative colitis
Aims: The endoscopic evaluation is crucial for the management and treatment of ulcerative colitis (UC). Currently, the Mayo Endoscopic Score (MES) and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) are two major endoscopic score systems to evaluate the status of mucosal inflammation and...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-12-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/1756284820981210 |
| _version_ | 1819078182313132032 |
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| author | Liang Chen Jiaolan Yang Leilei Fang Wei Wu Baisui Feng Yanhong Shi Mingming Sun Xiaomin Sun Zhanju Liu |
| author_facet | Liang Chen Jiaolan Yang Leilei Fang Wei Wu Baisui Feng Yanhong Shi Mingming Sun Xiaomin Sun Zhanju Liu |
| author_sort | Liang Chen |
| collection | DOAJ |
| description | Aims: The endoscopic evaluation is crucial for the management and treatment of ulcerative colitis (UC). Currently, the Mayo Endoscopic Score (MES) and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) are two major endoscopic score systems to evaluate the status of mucosal inflammation and disease activity. However, in both MES and UCEIS systems, the disease extent is not included. The Degree of Ulcerative Colitis Burden of Luminal Inflammation (DUBLIN) score is a simple clinical score which is calculated as a product of the MES (0–3) and the extent of disease (E1–E3). The objective of this study was to compare the correlation among DUBLIN, UCEIS and MES, and also investigate the clinical characteristics for predicting treatment failure in patients with active UC. Methods: Between March 2015 and April 2019, 172 patients who were previously diagnosed with UC and had undergone colonoscopy were recruited in this study. We retrospectively reviewed the endoscopic scores and clinical characteristics at the time of the colonoscopy and assessed the prognosis of the patients. Endoscopic response was defined as the decrease in MES ⩾1 grade. Results: DUBLIN showed significant correlation with MES ( r = 0.748) and partial Mayo score (pMayo) ( r = 0.707), and moderately correlated with CRP ( r = 0.590). UCEIS also showed strong correlation with MES ( r = 0.712) but moderate correlation with pMayo ( r = 0.609) and CRP ( r = 0.588). Compared with the UCEIS (cut-off value: 4; sensitivity: 75.73%), DUBLIN score (cut-off value: 4; sensitivity: 86.41%) showed higher diagnostic sensitivity than UCEIS score (McNemar test, p < 0.05). Furthermore, a multivariate analysis also revealed that DUBLIN ⩾4 was the independent factor for predicting treatment failure for UC ( p < 0.001, odds ratio: 1.547; 95% confidence interval: 1.32–1.88). Conclusion: The DUBLIN score shows superior diagnostic performances in terms of sensitivity value compared with the UCEIS. Moreover, multivariate analysis indicates that DUBLIN ⩾4 is an independent factor for predicting medium- to long-term treatment failure in active UC patients. |
| first_indexed | 2024-12-21T19:09:01Z |
| format | Article |
| id | doaj.art-43b6977ac54f4950a2296e32cc305093 |
| institution | Directory Open Access Journal |
| issn | 1756-2848 |
| language | English |
| last_indexed | 2024-12-21T19:09:01Z |
| publishDate | 2020-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj.art-43b6977ac54f4950a2296e32cc3050932022-12-21T18:53:15ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482020-12-011310.1177/1756284820981210The Degree of Ulcerative Colitis Burden of Luminal Inflammation score is superior to predicting medium- to long-term prognosis in patients with active ulcerative colitisLiang ChenJiaolan YangLeilei FangWei WuBaisui FengYanhong ShiMingming SunXiaomin SunZhanju LiuAims: The endoscopic evaluation is crucial for the management and treatment of ulcerative colitis (UC). Currently, the Mayo Endoscopic Score (MES) and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) are two major endoscopic score systems to evaluate the status of mucosal inflammation and disease activity. However, in both MES and UCEIS systems, the disease extent is not included. The Degree of Ulcerative Colitis Burden of Luminal Inflammation (DUBLIN) score is a simple clinical score which is calculated as a product of the MES (0–3) and the extent of disease (E1–E3). The objective of this study was to compare the correlation among DUBLIN, UCEIS and MES, and also investigate the clinical characteristics for predicting treatment failure in patients with active UC. Methods: Between March 2015 and April 2019, 172 patients who were previously diagnosed with UC and had undergone colonoscopy were recruited in this study. We retrospectively reviewed the endoscopic scores and clinical characteristics at the time of the colonoscopy and assessed the prognosis of the patients. Endoscopic response was defined as the decrease in MES ⩾1 grade. Results: DUBLIN showed significant correlation with MES ( r = 0.748) and partial Mayo score (pMayo) ( r = 0.707), and moderately correlated with CRP ( r = 0.590). UCEIS also showed strong correlation with MES ( r = 0.712) but moderate correlation with pMayo ( r = 0.609) and CRP ( r = 0.588). Compared with the UCEIS (cut-off value: 4; sensitivity: 75.73%), DUBLIN score (cut-off value: 4; sensitivity: 86.41%) showed higher diagnostic sensitivity than UCEIS score (McNemar test, p < 0.05). Furthermore, a multivariate analysis also revealed that DUBLIN ⩾4 was the independent factor for predicting treatment failure for UC ( p < 0.001, odds ratio: 1.547; 95% confidence interval: 1.32–1.88). Conclusion: The DUBLIN score shows superior diagnostic performances in terms of sensitivity value compared with the UCEIS. Moreover, multivariate analysis indicates that DUBLIN ⩾4 is an independent factor for predicting medium- to long-term treatment failure in active UC patients.https://doi.org/10.1177/1756284820981210 |
| spellingShingle | Liang Chen Jiaolan Yang Leilei Fang Wei Wu Baisui Feng Yanhong Shi Mingming Sun Xiaomin Sun Zhanju Liu The Degree of Ulcerative Colitis Burden of Luminal Inflammation score is superior to predicting medium- to long-term prognosis in patients with active ulcerative colitis Therapeutic Advances in Gastroenterology |
| title | The Degree of Ulcerative Colitis Burden of Luminal Inflammation score is superior to predicting medium- to long-term prognosis in patients with active ulcerative colitis |
| title_full | The Degree of Ulcerative Colitis Burden of Luminal Inflammation score is superior to predicting medium- to long-term prognosis in patients with active ulcerative colitis |
| title_fullStr | The Degree of Ulcerative Colitis Burden of Luminal Inflammation score is superior to predicting medium- to long-term prognosis in patients with active ulcerative colitis |
| title_full_unstemmed | The Degree of Ulcerative Colitis Burden of Luminal Inflammation score is superior to predicting medium- to long-term prognosis in patients with active ulcerative colitis |
| title_short | The Degree of Ulcerative Colitis Burden of Luminal Inflammation score is superior to predicting medium- to long-term prognosis in patients with active ulcerative colitis |
| title_sort | degree of ulcerative colitis burden of luminal inflammation score is superior to predicting medium to long term prognosis in patients with active ulcerative colitis |
| url | https://doi.org/10.1177/1756284820981210 |
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