Document Detail


Predictive factors of outcome of intensive intravenous treatment for attacks of ulcerative colitis.
MedLine Citation:
PMID:  10735919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intensive intravenous treatment remains the first line therapy of severe, uncomplicated attacks of ulcerative colitis. AIM: To predict the failure of intensive intravenous treatment by combining clinical and laboratory parameters with endoscopy findings. METHODS: Retrospective study conducted in a tertiary care referral centre. Failure of intensive intravenous treatment was defined as colectomy before day 30, intravenous cyclosporin, or death. Predictive factors of outcome were assessed using univariate and multivariate prognostic analysis. RESULTS: Between January 1990 and May 1997, 85 consecutive patients were treated with intensive intravenous treatment for non-response to oral corticosteroids (n=59) and/or severe attack of ulcerative colitis (n=26). There were 41 successes and 44 failures (including 1 death, 13 cyclosporin and 30 colectomies before day 30). Multivariate prognostic analysis found that the presence of Truelove and Witts' criteria (P=0.018), an attack that had lasted more than 6 weeks (P=0.001), and severe endoscopic lesions (P=0.007) were associated with an increased risk of failure. Patients with severe endoscopic lesions and Truelove and Witts' criteria, or an attack of more than 6 weeks had a failure rate of 85-86%. CONCLUSION: Clinical, laboratory and endoscopic findings can predict the risk of failure of intensive intravenous treatment. A prospective study is required to confirm these results.
Authors:
F Carbonnel; D Gargouri; M Lémann; L Beaugerie; S Cattan; J Cosnes; J P Gendre
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  14     ISSN:  0269-2813     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-04-27     Completed Date:  2000-04-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  273-9     Citation Subset:  IM    
Affiliation:
Service d'Hépatogastroentérologie et Nutrition, Hôpital Rothschild, Paris, France. digestif@imm.fr
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / administration & dosage,  therapeutic use
Adult
Anti-Inflammatory Agents / administration & dosage,  therapeutic use
Colitis, Ulcerative / mortality,  therapy*
Colonoscopy
Female
Follow-Up Studies
Humans
Injections, Intravenous
Intensive Care
Male
Prognosis
Retrospective Studies
Risk Factors
Steroids
Treatment Failure
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents; 0/Steroids

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