A simple clinical colitis activity index

Abstract

Background: The appropriate medical treatment of patients with ulcerative colitis is determined largely by the severity of symptoms. Hospital assessment of the severity of disease activity includes investigation of laboratory indices and sigmoidoscopic assessment of mucosal inflammation.

Aims: To develop a simplified clinical colitis activity index to aid in the initial evaluation of exacerbations of colitis.

Methods: The information for development of the simple index was initially evaluated in 63 assessments of disease activity in patients with ulcerative colitis where disease activity was evaluated using the Powell-Tuck Index (which includes symptoms, physical signs, and sigmoidoscopic appearance). The new index was then further evaluated in 113 assessments in a different group of patients, by comparison with a complex index utilising clinical and laboratory data, as well as five haematological and biochemical markers of disease severity.

Results: The newly devised Simple Clinical Colitis Activity Index, consisting of scores for five clinical criteria, showed a highly significant correlation with the Powell-Tuck Index (r = 0.959, p < 0.0001) as well as the complex index (r = 0.924, p < 0.0001) and all laboratory markers (p = 0.0003 to p < 0.0001).

Conclusions: This new Simple Colitis Activity Index shows good correlation with existing more complex scoring systems and therefore could be useful in the initial assessment of patients with ulcerative colitis.

Figure 1

Scattergram showing the relation between the Powell-Tuck Index and the new Simple Clinical Colitis Activity Index (n=63, r=0.959, p<0.0001, Spearman's rank correlation).

Figure 2

Scattergram showing the relation between the complex disease activity index scores and the Simple Clinical Colitis Activity Index (n=110, r=0.924, p<0.0001, Spearman's rank correlation).