The Perianal Crohn's Disease Activity Index can be used to evaluate a patient with Crohn's Disease showing perianal involvement. It can be used to monitor the response of the patient to therapeutic intervention. The authors are from McMaster University in Hamilton, Canada.
Parameters:
(1) discharge
(2) pain and restriction of activities
(3) restriction of sexual activity
(4) type of perianal disease
(5) degree of induration
|
Parameter |
Finding |
Points |
|---|---|---|
|
discharge |
none |
0 |
|
|
minimal mucous discharge |
1 |
|
|
moderate mucous or purulent discharge |
2 |
|
|
substantial discharge |
3 |
|
|
gross fecal soiling |
4 |
|
pain and restriction of activities |
no activity restriction |
0 |
|
|
mild discomfort; no restriction on activities |
1 |
|
|
moderate discomfort; some limitation of activities |
2 |
|
|
marked discomfort; marked limitation of activities |
3 |
|
|
severe pain; severe limitation of activities |
4 |
|
restriction of sexual activity |
none |
0 |
|
|
slight |
1 |
|
|
moderate |
2 |
|
|
marked |
3 |
|
|
unable to engage in sexual activity |
4 |
|
type of perianal disease |
none |
0 |
|
|
skin tags |
0 |
|
|
anal fissure or mucosal tear |
1 |
|
|
< 3 perianal fistulas |
2 |
|
|
>= 3 perianal fistulas |
3 |
|
|
anal sphincter ulceration |
4 |
|
|
fistulas with substantial undermining of skin |
4 |
|
degree of induration |
none |
0 |
|
|
minimal |
1 |
|
|
moderate |
2 |
|
|
substantial |
3 |
|
|
gross fluctuance |
4 |
|
|
abscess |
4 |
activity index =
= SUM(points for all 5 parameters)
Interpretation:
• minimum index: 0
• maximum index: 20
• The higher the index, the more severe the perianal involvement.
Performance:
• The index showed responsiveness to the clinical status of the patient, with clinical improvement associated with lowering of the index.
• The index correlated with both the physician and patient global assessments of perianal disease activity.
• According to Schwartz et al, the index still needs to be fully validated.
Purpose: To evaluate the extent of perianal involvement in a patient with Crohn's disease using the Crohn's Disease Perianal Activity Index.
Specialty: Gastroenterology
Objective: severity, prognosis, stage, disease progression
ICD-10: K50,
