UCEIS?MES And The Ratio Of Platelet To Hemoglobin Of Predicting Need Of Colectomy In Patients With Severe Ulcerative Colitis

Part OneTo evaluate and compare the clinical significance of Ulcerative Colitis Endoscopic Severity Index(UCEIS)and Mayo Endoscopic Score(MES)in the management of severe acute ulcerative colitisObjective:By comparing the accuracy and sensitivity of ulcerative colitis endoscopic severity index and Mayo endoscopic scoring for predicting the surgical risk of acute severe ulcerative colitis,more accurate scoring criteria were selected to guide clinical to identificate the patiens who may be failed medical treatment and need surgery.Methods:A retrospective review of ASUC patients admitted to our hospital between January 2014 and May 2016 was conducted.The main observations included:baseline data,previous treatment history,clinical manifestations,laboratory tests,medications,and endoscopic findings.The primary endpoint was surgical treatment of severe ulceration during hospitalization or follow-upResults:A total of 92 patients were included in the study.37(40.2%)required colectomy.Multivariate analysis showed that:UCEIS index had predictive significance for severe ulcer surgical treatment(OR,3.25;95%CI,1.77-5.97;P<0.001).The area under the ROC curve was 0.85,the sensitivity was 60.3%,and the specificity was 85.5%,which was better than 0.65 for MES.At the same time,when the UCEIS score was?7,80%of patients eventually needed surgery.Conclusion:This study found that UCEIS,a predictor of colectomy for patients with ASC,is superior to MES.When the UCEIS score was greater than 7 points,it was suggested that the patient's medical treatment failed because of the possible high surgical treatment.Part TwoThe ratio of platelet to hemoglobin:Predicting the risk of surgical in severe acute ulcerative colitisObjective:Through univariate and multivariate analysis,the risk factors for sterior therapy failure were identified,and UCEIS was validated for predicting the effectiveness of hormone therapy in ASUC.At the same time,the correlation between platelet and hemoglobin ratios and UCEIS was found.Substituting UCEIS as a predictor of the therapeutic efficacy of hormone therapy guides clinically accurate identification of patients in the clinic who may have failed drug treatment and require surgical treatment.Methods:We retrospectively evaluated ASUC patients admitted to our hospital from January 2016 to December 2017.The main observations included:baseline data,previous treatment history,clinical manifestations,laboratory tests,medications,and endoscopic findings.The primary endpoint was surgical treatment of severe ulceration during hospitalization or follow-up.Results:The studyincluded a total of 99 patients.37(37.4%)required colectomy.Multivariate analysis showed that:The ratio of platelet to hemoglobin at admission was predictive of surgical treatment for severe invasive corticosteroid therapy(OR,8.77;95%CI,6.13 to 9.98;P<0.001).The area under the ROC curve was 0.85,the sensitivity was 64%,and the specificity was 88%.At the same time,when the ratio of platelet to hemoglobin?6.50,80%of patients eventually needed surgery.Conclusion:This study found that the platelet to hemoglobin ratio can be used to predict the risk factors for early surgical treatment of severe acute ulcerative colitis.When the ratio is greater than 6.50,it is highly probable that the patient needs medical treatment because of failure of drug treatment.