Introduction A new index has been shown to predict acute severe colitis (ASC) in ulcerative colitis (UC) patients at diagnosis (1). When applied to patients at the time of diagnosis, and using 3 simple parameters, this scoring system predicts the 3 year risk of developing ASC. 1 point is given for extensive disease, 1 point for a C-reactive protein [CRP] >10 mg/L, and 1 point for a haemoglobin [Hb] <12 g/dl F or <14 g/dl M. A score of 3/3 gives a 70% predicted risk of developing ASC within 3 years. This index was developed in an Oxford UC cohort, and externally validated in cohorts in Cambridge (UK) and Uppsala (Sweden), all of which are predominantly Caucasian populations. We have previously demonstrated that North West London South Asian patients tend to have extensive disease, but with a low colectomy rate (2), suggesting extensive disease is not a marker of severity in this population. This study was perofrmed to assess the accuracy of this index in a South Asian population.
Method South Asian UC patients diagnosed between January 2006 and December 2013 were identified from the hospital’s IBD research database. Patients were included if the extent of disease, CRP and Hb data were accessible at the time of diagnosis. Electronic notes were accessed to provide follow up data regarding admissions and treatment in the 3 years following diagnosis. Patients lost to follow up were excluded.
Results 48 UC SA patients were identified over the study period who had the requisite clinical data available to enable a predictive score to be calculated. 6/48 of these patients developed ASC within 3 years of diagnosis. In all index score categories, South Asians patients had a lower percentage of ASC compared to the Oxford median predictive risk.
South Asian cohort stratified by index score and number with ASC - Side to side comparison with Oxford Development cohort.
Conclusion This study suggests that this index over estimated the risk of developing ASC in a South Asian population, which would affect the utility of this index in SA patients where more extensive but less aggressive disease has been demonstrated. Larger studies are needed to confirm these findings.
. Cesarini M. J Crohns Colitis2016.
. Walker DG. Am J Gastroenterol2011.
Disclosure of Interest None Declared
- Acute severe colitis
- Inflammatory Bowel Disease
- South Asians
- Ulcerative colitis
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