Abstract | Background:
Ulcerative colitis (UC) is a chronic lifelong disease. The disease extent of UC can progress over time. This study aimed to assess whether cumulative inflammatory burden (CIB) is associated with disease extension in distal UC ( proctitis [E1] and left-sided colitis [E2]) patients, and to develop a quantified indicator of CIB. Methods: In this retrospective study based on a prospective registry, distal UC patients receiving colonoscopies in Xijing Hospital (Xi'an, China) from January 2000 to May 2019 were studied. We developed a new score, namely the time-adjusted average Mayo endoscopic score (TA-MES), calculated as dividing the sum of the cumulative average MES over a period of surveillance time by the length of the endoscopic examination interval, to quantify the CIB. Cox regression was used to identify other potential risk factors. Results: A total of 295 UC patients were followed for 1,487.02 patient-years. Among them, 140 patients (47.5%) experienced disease extension. Multivariate analysis showed that the TA-MES was significantly associated with disease extension in E1 (hazard ratio [HR], 2.90; 95% confidence interval [CI], 1.58-5.33, P = 0.001) and E2 (HR, 1.89; 95% CI, 1.16-3.09, P = 0.011) patients. Other risk factors included hemoglobin of <90 g/L and appendiceal skip inflammation; the protective factors included age, E2 at diagnosis, former smoking, and 5-aminosalicylic acid dose. Otherwise, MES at diagnosis, maximal MES, and mean MES failed to estimate the risk of disease extension. Conclusion: TA-MES is a good quantified indicator of CIB and is independently associated with increased disease extension in distal UC patients. Whether the dynamic multiple scoring system could be used as a risk factor in other chronic relapsing-remitting diseases is a direction for future research.
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Authors | Jian Wan, Xuan Wang, Yujie Zhang, Xianmin Xue, Hui Jia, Min Wang, Jie Liang, Kaichun Wu |
Journal | Gastroenterology report
(Gastroenterol Rep (Oxf))
Vol. 10
Pg. goac019
( 2022)
ISSN: 2052-0034 [Print] England |
PMID | 35599745
(Publication Type: Journal Article)
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Copyright | © The Author(s) 2022. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-sen University. |