Association Between the @entity31 Endoscopic Index of Severity (UCEIS) and Outcomes in Acute XXXX .

@entity1 @entity31 @entity1960 @entity205 @entity701 @entity230
BACKGROUND: The @entity31 Endoscopic Index of Severity (UCEIS) accounts for 86% of the variance between observers in the overall assessment of endoscopic severity, but has not been correlated with outcomes. METHODS: Consecutive cases of acute severe @entity1960 (ASC) defined by Truelove and Witts (TW) criteria were retrospectively evaluated. Demographic details, number of TW criteria, prior medical therapy, UCEIS and inpatient medical therapy were recorded. Pre-specified (adverse) endpoints included rescue therapy, colectomy and readmission. RESULTS: Eighty-nine @entity1 , 48 (54%) male, mean age 38 years, all received intravenous @entity701 400mg/d (median 5 days [range 1-11]). Median follow-up was 14 months (2-33). Forty-eight (54%) were diagnosed the year prior to or at the time of admission. Thirty-six (40%) required rescue therapy (infliximab 25/36, @entity205 12/36, one receiving both). Twenty-one (24%) underwent colectomy on the index admission (9/21) or during follow-up (12/21). Median UCEIS score (possible range 0-8) was 5 (3-8). UCEIS was higher in @entity1 requiring rescue therapy or colectomy (median score 6 [range 4-8] versus 5/8 [3-8], both p < 0.005). For UCEIS >= 5, 27/54 (50%) required rescue therapy, compared with 9/33 (27%) for UCEIS  <=4 (p = 0.037). When UCEIS was >= 5, 18/54 (33%) came to colectomy during follow-up, compared with 3/33 (9%) with UCEIS  <=4. Of 14 @entity1 with UCEIS 7 or 8, 11/14 needed rescue therapy and 13/14 met any adverse endpoint. CONCLUSION: Endoscopic severity is associated with a worse outcome in ASC. When the UCEIS is >= 7 on admission, almost all @entity1 will need treatment with infliximab or @entity205 beyond @entity230 . This may mark a threshold for an early decision to use infliximab or @entity205 .
