FEl Rhaoussi, S Banani*, M Tahiri, F Haddad, W Hliwa, A Bellebah and W Badre

Hepato-Gastro-Enterology Department, University Hospital IBN ROCHD, Casablanca, Morocco

*Corresponding Author: S Banani, Hepato-Gastro-Enterology Department, University Hospital IBN ROCHD, Casablanca, Morocco.

Received: January 10, 2025; Published: February 12, 2025

Abstract

Patients with acute severe ulcerative colitis (ASUC) have a lifetime risk of an acute flare requiring hospital stay. The diagnosis of ASUC is based on Truelove and Witts criteria and the treatment by intravenous steroids showed improved clinical remission and reduced mortality. However, some patients respond poorly to systemic steroids and need a medical treatment by anti TNF agents or a surgical treatment by colectomy. The aim of our study was to identify the predictive factors of colectomy during acute severe ulcerative colitis. We conducted a retrospective study on the Hepato gastro enterology department in IBN Rochd University Hospital of CASABLANCA, including all the admissions of patients with acute severe ulcerative colitis between 2016 and 2023.

Younger age (< 20 years) and inaugural acute severe ulcerative colitis was significantly associated with a higher risk of colectomy (p = 0.019; p = 0.001). Elevated C-reactive protein (>45) at day 3 (p = 0.004), decreased albumin level (< 30g/L) (p = 0.02) and positive oxford criteria (p < 0.01) was also significantly associated with colectomy risk. The ACE score calculated in our patients, and a higher score of three was significantly associated to a major risk of colectomy (p = 0,024). According to multivariate analysis, the predictive factors of colectomy was a positive Travis score at day 3(p = 0,028).

The algorithm of management of ASUC should be quick to perform, assisting decision- making in real time and be simple enough for clinicians to remember. In our study, we confirm the importance of evaluating Travis score and the ACE score in order to predict the risk of non-response and surgery.

Keywords: Acute Severe Ulcerative Colitis; Steroids; Colectomy; Travis Score; The ACE Score

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Citation

Citation: S Banani., et al. “Predictive Factors of Colectomy During Acute Severe Ulcerative Colitis".Acta Scientific Gastrointestinal Disorders 8.3 (2025): 13-17.

Copyright

Copyright: © 2025 S Banani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.