Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul;60(7):716-727.
doi: 10.1080/00365521.2025.2512591. Epub 2025 Jun 8.

Predicting severe inflammatory bowel disease: a risk matrix model based on the IBSEN III inception cohort

Vibeke Strande  1   2   3 , Milada Hagen  4   5 , Charlotte Lund  2   4 , Øyvind Asak  6 , May-Bente Bengtson  7 , Raziye Boyar  8 , Trond Espen Detlie  9 , Svein Oskar Frigstad  10 , Magne Henriksen  11 , Kristina I Aass Holten  2   11 , Øistein Hovde  2   12 , Gert Huppertz-Hauss  13 , Ole Høie  14 , Ingunn Johansen  15   16 , Asle W Medhus  2   4 , Bjørn Christian Olsen  2   13 , Randi Opheim  4   16 , Gøri Perminow  17 , Petr Ricanek  3   9 , Roald Torp  18 , Jørgen Valeur  1   2   3 , Simen Vatn  9   12 , Tone Bergene Aabrekk  2   7 , Bjørn Moum  2   19 , Marte Lie Høivik  2   4 , Vendel A Kristensen  2   4
Affiliations
Free article

Predicting severe inflammatory bowel disease: a risk matrix model based on the IBSEN III inception cohort

Vibeke Strande et al. Scand J Gastroenterol. 2025 Jul.
Free article

Abstract

Background and aims: Identifying patients at risk of developing severe inflammatory bowel disease (IBD) can aid treatment decisions. However, predicting disease course remains challenging. We aimed to identify predictive factors associated with severe disease course in the first year after IBD diagnosis.

Methods: Newly diagnosed adult (≥18 years) patients with IBD were recruited from a population-based inception cohort (IBSEN III study). Preselected baseline factors were tested for associations with severe disease course, defined as IBD-related hospitalisation, surgery, treatment with ≥2 steroid courses, >2 biologics and/or new event of complication (stricture, fistula, abscess only applicable Crohn's disease (CD)). From a best fitted multivariable logistic regression model stratified by diagnosis and age (18-40/>40 years), probability of severe disease for given combinations of predictive factors was summarised in prediction matrices.

Results: At one-year follow-up, 90/559 (16%) patients with ulcerative colitis (UC) and 74/312 (24%) with CD had severe disease. Treatment with systemic steroids, vitamin D deficiency, Simple Clinical Colitis Activity Index >2, and hypoalbuminemia at diagnosis were all significantly associated with severe disease in UC patients. CD patients with stricturing or penetrating disease behaviour, systemic steroids and hypoalbuminemia at diagnosis were associated with severe disease course. The least favourable combination of these factors increased the probability of severe disease from 3% (95%CI[0-5%]) to 72% (95%CI[66-79%]) for UC and from 8% (95%CI[3-13%]) to 88% (95%CI[84-93%]) for CD.

Conclusions: Our study identified predictive factors associated with severe disease the first year after diagnosis. The probability of severe disease summarised in matrices enables easy risk stratification.

Keywords: Crohn’s disease; Ulcerative colitis; predictive factors; severe disease course.

PubMed Disclaimer

MeSH terms

LinkOut - more resources