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Predicting the Indi...
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Cesarini, MonicaOxford Univ Hosp, Translat Gastroenterol Unit, Oxford, England.;Sapienza Univ Rome, Dipartimento Med Interna & Specialita Med, Rome, Italy.
(author)
Predicting the Individual Risk of Acute Severe Colitis at Diagnosis
- Article/chapterEnglish2017
Publisher, publication year, extent ...
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2016-09-19
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OXFORD UNIV PRESS,2017
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-320855
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-320855URI
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https://doi.org/10.1093/ecco-jcc/jjw159DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Background and Aims: Acute severe colitis [ASC] is associated with major morbidity. We aimed to develop and externally validate an index that predicted ASC within 3 years of diagnosis. Methods: The development cohort included patients aged 16-89 years, diagnosed with ulcerative colitis [UC] in Oxford and followed for 3 years. Primary outcome was hospitalization for ASC, excluding patients admitted within 1 month of diagnosis. Multivariable logistic regression examined the adjusted association of seven risk factors with ASC. Backwards elimination produced a parsimonious model that was simplified to create an easy-to-use index. External validation occurred in separate cohorts from Cambridge, UK, and Uppsala, Sweden. Results: The development cohort [Oxford] included 34/111 patients who developed ASC within a median 14 months [range 1-29]. The final model applied the sum of 1 point each for extensive disease, C-reactive protein [CRP] >10 mg/l, or haemoglobin < 12 g/dl F or < 14 g/dl M at diagnosis, to give a score from 0/3 to 3/3. This predicted a 70% risk of developing ASC within 3 years [score 3/3]. Validation cohorts included different proportions with ASC [Cambridge = 25/96; Uppsala = 18/298]. Of those scoring 3/3 at diagnosis, 18/18 [Cambridge] and 12/13 [Uppsala] subsequently developed ASC. Discriminant ability [c-index, where 1.0 = perfect discrimination] was 0.81 [Oxford], 0.95 [Cambridge], 0.97 [Uppsala]. Internal validation using bootstrapping showed good calibration, with similar predicted risk across all cohorts. A nomogram predicted individual risk. Conclusions: An index applied at diagnosis reliably predicts the risk of ASC within 3 years in different populations. Patients with a score 3/3 at diagnosis may merit early immunomodulator therapy.
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Collins, Gary S.Univ Oxford, Ctr Stat Med, Oxford, England.
(author)
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Rönnblom, AndersUppsala universitet,Gastroenterologi/hepatologi(Swepub:uu)anderonn
(author)
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Santos, AntonietaCambridge Univ Hosp, Gastroenterol Unit, Cambridge, England.;Hosp Amato Lusitano, Gastroenterol Unit, Castelo Branco, Portugal.
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Wang, Lai MunOxford Univ Hosp, Dept Cellular Pathol, Oxford, England.
(author)
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Sjöberg, Daniel,1974-Uppsala universitet,Gastroenterologi/hepatologi(Swepub:uu)dansj439
(author)
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Parkes, MilesOxford Univ Hosp, Translat Gastroenterol Unit, Oxford, England.
(author)
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Keshav, SatishOxford Univ Hosp, Translat Gastroenterol Unit, Oxford, England.
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Travis, Simon P. L.Oxford Univ Hosp, Translat Gastroenterol Unit, Oxford, England.
(author)
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Oxford Univ Hosp, Translat Gastroenterol Unit, Oxford, England.;Sapienza Univ Rome, Dipartimento Med Interna & Specialita Med, Rome, Italy.Univ Oxford, Ctr Stat Med, Oxford, England.
(creator_code:org_t)
Related titles
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In:Journal of Crohn's & Colitis: OXFORD UNIV PRESS11:3, s. 335-3411873-99461876-4479
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Cesarini, Monica
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Collins, Gary S.
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Rönnblom, Anders
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Santos, Antoniet ...
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Wang, Lai Mun
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Sjöberg, Daniel, ...
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Parkes, Miles
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Keshav, Satish
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Travis, Simon P. ...
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Journal of Crohn ...
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Uppsala University