Validation of the Ulcerative Colitis Colonoscopic Index of Severity and Its Correlation With Disease Activity Measures

被引：115

作者：

Samuel, Sunil ^{[1
,2
,3
]}

Bruining, David H. ^{[1
]}

Loftus, Edward V., Jr. ^{[1
]}

Thia, Kelvin T. ^{[4
]}

Schroeder, Kenneth W. ^{[1
]}

Tremaine, William J. ^{[1
]}

Faubion, William A. ^{[1
]}

Kane, Sunanda V. ^{[1
]}

Pardi, Darrell S. ^{[1
]}

de Groen, Piet C. ^{[1
]}

Harmsen, William S. ^{[5
]}

Zinsmeister, Alan R. ^{[5
]}

Sandborn, William J. ^{[6
]}

机构：

[1] Mayo Clin, Div Gastroenterol & Hepatol, Rochester, MN USA

[2] Univ Nottingham, Nottingham Digest Dis Ctr, Natl Inst Hlth Res, Biomed Res Unit, Nottingham NG7 2RD, England

[3] Nottingham Univ Hosp NHS Trust, Nottingham, England

[4] Singapore Gen Hosp, Singapore, Singapore

[5] Mayo Clin, Div Biomed Stat & Informat, Rochester, MN USA

[6] Univ Calif San Diego, Div Gastroenterol, La Jolla, CA 92093 USA

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2013年 / 11卷 / 01期

关键词：

Diagnostic; IBD; Patient Management; Response to Therapy; INFLAMMATORY-BOWEL-DISEASE; INTEROBSERVER AGREEMENT; 5-AMINOSALICYLIC ACID; END-POINTS; THERAPY; PATCHINESS; INFLIXIMAB; OBSERVERS; TIME;

D O I：

10.1016/j.cgh.2012.08.003

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

BACKGROUND & AIMS: Endoscopic healing is likely to become an important goal for treatment of patients with ulcerative colitis (UC). A simple validated endoscopic index is needed. We validated the previously developed UC Colonoscopic Index of Severity (UCCIS). METHODS: In a prospective study, 50 patients with UC were examined by colonoscopy; we analyzed videos of rectum and sigmoid, descending, transverse, and cecum/ascending colon. Eight gastroenterologists blindly rated 4 mucosal lesions (for vascular pattern, granularity, friability, ulceration) and severity of damage to each segment and overall. The global assessment of endoscopic severity (GAES) was based on a 4-point scale and 10-cm visual analogue scale. Correlation of the UCCIS score with clinical indexes (clinical activity index and simple clinical colitis activity index), patient-defined remission, and laboratory measures of disease activity (levels of C-reactive protein, albumin, and hemoglobin and platelet counts) were estimated by using the Pearson (r) or Spearman (r(s)) method. RESULTS: Interobserver agreement was good to excellent for the 4 mucosal lesions evaluated by endoscopy and the GAES. The UCCIS calculated for our data accounted for 74% (R-2 = 0.74) and 80% (R-2 = 0.80) of the variation in the GAES and visual analogue scores, respectively (P < .0001). The UCCIS also correlated with clinical activity index (r = 0.52, P < .001), simple clinical colitis activity index (r = 0.62, P < .0001), and patient-defined remission (r = 0.43, P < .01). The UCCIS also correlated with levels of C-reactive protein (r(s) = 0.56, P < .001), albumin (r = -0.55, P < .001), and hemoglobin (r = -0.39, P < .01). A rederivation of the equation for the UCCIS by using the data from a previous study combined with those of the current study (n = 101) yielded similar results. CONCLUSIONS: The UCCIS is a simple tool that provides reproducible results in endoscopic scoring of patients with UC.

引用

页码：49 / U178

页数：7

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