Predictive factors of glucocorticosteroid treatment failure in severe acute idiopathic colitis

The purpose of our study was to determine clinical, biological or endoscopic factors that could predict glucocorticosteroid treatment failure in acute colitis.

Fifty-four Tunisian Caucasian patients with acute idiopathic colitis (ulcerative colitis in 53 patients, Crohn's colitis in 1 patient) have been evaluated. Non-therapeutic response was defined as over 6 bowel movements per day, blood visible to the naked eye in stools on the fifth day after admission or the development of a complication inducing a resort to surgery. Predictive factors were assessed using bivariate and multivariate analysis.

Thirty-nine patients (72.2%) had no medical response. In univariate analysis, predictive factors of therapeutic failure were: male sex, tobacco, previous history of colitis attacks, bowel movements per day over seven at admission and on day three, and pulse rate over 90/mn, temperature over 38 degrees C, systolic blood pressure below 11 on day 3 and on day 5 after admission. In multivariate analysis, bowel movements over seven per day on day 3 of hospitalization and male sex independently predicted a failure of glucorticosteroid treatment.

Bowel movements per day over seven on day 3 of hospitalization and male sex were the independently predictive factors of failure of glucocorticosteroid treatment.