Siegel et all developed an index to define the overall disease severity in ulcerative colitis. This can help to monitor the patient over time and any response to therapy. The authors are from multiple institutions from the United States, Canada, Europe, New Zealand and Hong Kong.
Patient selection: ulcerative colitis
Outcome: overall disease activity
Parameters:
(1) mucosal lesions (confirmed by endoscopy)
(2) recent disease-related hospitalizations in past 12 months
(3) nocturnal bowel movements
(4) rectal bleeding
(5) disease extent
(6) frequency of loose stools per week
(7) CRP level in mg/L
(8) use of biologics
(9) impact on daily activities
(10) serum albumin level in g/dL
(11) anorectal symptoms (anorectal pain, bowel urgency, incontinence, discharge, tenesmus)
(12) anemia (by WHO criteria for age and gender)
(13) steroid use in past year
Parameter |
Finding |
Points |
mucosal lesions |
none |
0 |
|
active erosions |
14 |
|
active ulcers |
18 |
recent hospitalization |
absent |
0 |
|
present |
8 |
nocturnal bowel movements |
absemt |
0 |
|
present |
4 |
rectal bleeding |
none |
0 |
|
present |
3 |
disease extent |
distal colitis (can be treated with enemas) |
0 |
|
extensive |
5 |
frequency of loose stools |
not increased |
0 |
|
increased one per day compared to baseline |
4 |
|
increased by 2 or more |
5 |
CRP level |
normal (<= 3 mg/L) |
0 |
|
3.01 to 5 mg/L |
4 |
|
> 5 mg/L |
11 |
use of biologics |
never used |
0 |
|
some improvement with |
4 |
|
no improvement with |
10 |
daily activity impact |
none |
0 |
|
significantly impacts |
14 |
serum albumin |
>= 3.5 g/dL |
0 |
|
< 3.5 g/dL |
5 |
anorectal symptoms |
no symptoms |
0 |
|
any symptoms |
4 |
anemia |
absent |
0 |
|
present |
5 |
steroid use |
none in past year |
0 |
|
any in past year |
8 |
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: 0
• maximum score: 100
• The higher the score the more active the ulcerative colitis.
Specialty: Gastroenterology