Lichtinger et al developed a score for evaluating a patient with ulcerative colitis (UC). The authors are from Mt. Sinai School of Medicine in New York City and the University of Chicago.
Synonym: modified Truelove and Witts severity index, MTWSI
Parameters:
(1) number of stools per day
(2) diarrhea at night (nocturnal)
(3) percent of stools showing visible blood
(4) fecal incontinence
(5) abdominal pain or cramping
(6) patient's assessment of general well-being
(7) abdominal tenderness
(8) need for antidiarrheal drugs
|
Parameter |
Finding |
Points |
|---|---|---|
|
number of stools per day |
0 or 2 (normal) |
0 |
|
|
3 or 4 |
1 |
|
|
5 or 6 |
2 |
|
|
7 to 9 |
3 |
|
|
10 or more |
4 |
|
diarrhea at night |
no |
0 |
|
|
yes |
1 |
|
visible blood in stool |
0% of time (none) |
0 |
|
|
1 to 49% of time (some) |
1 |
|
|
50 to 95% of time (most) |
2 |
|
|
100% of the time (all) |
3 |
|
fecal incontinence |
no |
0 |
|
|
yes |
1 |
|
abdominal pain or cramping |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
general well-being |
excellent, perfect |
0 |
|
|
very good |
1 |
|
|
good |
2 |
|
|
average |
3 |
|
|
poor |
4 |
|
|
very poor, terrible |
5 |
|
abdominal tenderness |
none |
0 |
|
|
mild and localized |
1 |
|
|
mild to moderate and diffuse |
2 |
|
|
severe or rebound |
3 |
|
need for antidiarrheal drugs |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score the more severe the ulcerative colitis.
• A patient who is being treated for severe disease and who has a score less than 10 for 2 consecutive days has responded to the therapy.
Purpose: To evaluate a patient with ulcerative colitis (UC) using the index of Lichtinger et al.
Specialty: Gastroenterology
Objective: severity, prognosis, stage
ICD-10: K51,
