Ananthakrishnan et al developed 2 scores for predicting the risk that a patient hospitalized for Ulcerative Colitis (UC) will need to undergo a colectomy. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Medical College of Wisconsin and the University of Pittsburgh.
Patient selection: hospitalized patient with ulcerative colitis (excluding patients admitted for elective colectomy and for colorectal cancer)
The authors developed 2 scores for predicting the risk for total colectomy during the index hospital stay.
Parameters (based on ICD-9-CM codes):
(1) anemia
(2) need for blood transfusion
(3) malnutrition
(4) transfer from an outside hospital
(5) admission to a teaching hospital
(6) total parenteral nutrition (TPN)
(7) ulcerative pancolitis
Parameter |
Finding |
Points |
---|---|---|
anemia |
absent |
0 |
|
present |
1 |
need for blood transfusion |
no |
0 |
|
yes |
1 |
malnutrition |
absent |
0 |
|
present |
2 |
transfer from an outside hospital |
no |
0 |
|
yes |
1 |
admission to a teaching hospital |
no |
0 |
|
yes |
1 |
The first colectomy risk score uses the first 5 items plus the following one (total 6 parameters)
Parameter |
Finding |
Points |
---|---|---|
total parenteral nutrition |
no |
0 |
|
yes |
2 |
The second (modified) risk score uses the first 5 items plus the following 2 (total 7 parameters).
Parameter |
Finding |
Points |
---|---|---|
total parenteral nutrition |
no |
0 |
|
yes |
1 |
ulcerative pancolitis |
no |
0 |
|
yes |
2 |
total risk scores =
= SUM(points for all of the parameters)
Interpretation:
• minimum scores: 0
• maximum first score: 8
• maximum modified score: 9
• The higher the score the greater the risk for needing a total colectomy.
Total Score (Both Models) |
Risk for Total Colectomy |
---|---|
0 or 1 |
low |
2 or 3 |
moderate |
4 or more |
high |
Purpose: To identify a patient admitted to the hospital for ulcerative colitis (UC) who is more likely to undergo a total colectomy.
Specialty: Gastroenterology
Objective: risk factors, complications, failure handling and therapy escalation
ICD-10: K51,