The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up study

BackgroundThe simple endoscopic score for Crohn's disease (SES-CD) is a widely used index to evaluate clinical and endoscopic activity. However, the association and predictive value of SES-CD for intestinal obstruction in Crohn's disease (CD) remains unclear. We aimed to establish the best...

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Main Authors: Weimin Xu, Zhebin Hua, Yaosheng Wang, Yubei Gu, Jie Zhong, Long Cui, Peng Du
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-09-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2022.984029/full
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author Weimin Xu
Zhebin Hua
Yaosheng Wang
Yubei Gu
Jie Zhong
Long Cui
Peng Du
author_facet Weimin Xu
Zhebin Hua
Yaosheng Wang
Yubei Gu
Jie Zhong
Long Cui
Peng Du
author_sort Weimin Xu
collection DOAJ
description BackgroundThe simple endoscopic score for Crohn's disease (SES-CD) is a widely used index to evaluate clinical and endoscopic activity. However, the association and predictive value of SES-CD for intestinal obstruction in Crohn's disease (CD) remains unclear. We aimed to establish the best cut-off indicators of SES-CD for early clinical intervention and subsequent prevention of intestinal obstruction in CD.MethodsData on patients with CD evaluated at our institute from January 2016 to January 2022 were retrospectively collected. The SES-CD and Crohn's Disease Activity Index scores used in the analysis indicated the results of the first clinical and colonoscopy evaluations after hospitalization. The primary outcome was the occurrence of intestinal obstruction during admission and follow-up.ResultsA total of 248 patients with a median follow-up time of 2 years [interquartile range: 1.0–4.0] were enrolled, of which 28.2% developed intestinal obstruction. An SES-CD score of 8 was the most significant threshold evaluation, and SES-CD ≥8 had the largest area under the receiver operating characteristic curve (0.705), with a sensitivity of 52.9% and specificity of 88.2% in predicting intestinal obstruction. Furthermore, SES-CD ≥8 had the greatest risk factor for intestinal obstruction (odds ratio: 7.731; 95% confidence interval: 3.901–15.322; p < 0.001) and significantly decreased the overall intestinal obstruction-free survival (p < 0.001).ConclusionThe SES-CD endoscopic prediction model could be an effective predictor of intestinal obstruction in patients with CD. More frequent follow-up and colonoscopic surveillance should be considered in patients with SES-CD score ≥8 to prevent the development of intestinal obstruction.
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spelling doaj.art-8ae29835af0c4189be311b3ed70d13072022-12-22T04:36:56ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-09-01910.3389/fsurg.2022.984029984029The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up studyWeimin Xu0Zhebin Hua1Yaosheng Wang2Yubei Gu3Jie Zhong4Long Cui5Peng Du6Department of Colorectal Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Colorectal Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Colorectal Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Rui Jin Hospital, Affiliate to Shanghai Jiao Tong University, School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Rui Jin Hospital, Affiliate to Shanghai Jiao Tong University, School of Medicine, Shanghai, ChinaDepartment of Colorectal Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Colorectal Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaBackgroundThe simple endoscopic score for Crohn's disease (SES-CD) is a widely used index to evaluate clinical and endoscopic activity. However, the association and predictive value of SES-CD for intestinal obstruction in Crohn's disease (CD) remains unclear. We aimed to establish the best cut-off indicators of SES-CD for early clinical intervention and subsequent prevention of intestinal obstruction in CD.MethodsData on patients with CD evaluated at our institute from January 2016 to January 2022 were retrospectively collected. The SES-CD and Crohn's Disease Activity Index scores used in the analysis indicated the results of the first clinical and colonoscopy evaluations after hospitalization. The primary outcome was the occurrence of intestinal obstruction during admission and follow-up.ResultsA total of 248 patients with a median follow-up time of 2 years [interquartile range: 1.0–4.0] were enrolled, of which 28.2% developed intestinal obstruction. An SES-CD score of 8 was the most significant threshold evaluation, and SES-CD ≥8 had the largest area under the receiver operating characteristic curve (0.705), with a sensitivity of 52.9% and specificity of 88.2% in predicting intestinal obstruction. Furthermore, SES-CD ≥8 had the greatest risk factor for intestinal obstruction (odds ratio: 7.731; 95% confidence interval: 3.901–15.322; p < 0.001) and significantly decreased the overall intestinal obstruction-free survival (p < 0.001).ConclusionThe SES-CD endoscopic prediction model could be an effective predictor of intestinal obstruction in patients with CD. More frequent follow-up and colonoscopic surveillance should be considered in patients with SES-CD score ≥8 to prevent the development of intestinal obstruction.https://www.frontiersin.org/articles/10.3389/fsurg.2022.984029/fullCrohn’s diseaseCrohn’s disease activity indexsimple endoscopic score for Crohn’s diseaseintestinal obstructionpredictive value
spellingShingle Weimin Xu
Zhebin Hua
Yaosheng Wang
Yubei Gu
Jie Zhong
Long Cui
Peng Du
The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up study
Frontiers in Surgery
Crohn’s disease
Crohn’s disease activity index
simple endoscopic score for Crohn’s disease
intestinal obstruction
predictive value
title The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up study
title_full The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up study
title_fullStr The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up study
title_full_unstemmed The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up study
title_short The endoscopic prediction model of simple endoscopic score for Crohn’s disease (SES-CD) as an effective predictor of intestinal obstruction in Crohn’s disease: A multicenter long-term follow-up study
title_sort endoscopic prediction model of simple endoscopic score for crohn s disease ses cd as an effective predictor of intestinal obstruction in crohn s disease a multicenter long term follow up study
topic Crohn’s disease
Crohn’s disease activity index
simple endoscopic score for Crohn’s disease
intestinal obstruction
predictive value
url https://www.frontiersin.org/articles/10.3389/fsurg.2022.984029/full
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