Prediction of complications in inflammatory bowel disease using routine blood parameters at diagnosis

Patients with inflammatory bowel disease (IBD) can develop a series of complications over time, including fistulas and perforation, strictures and pseudopolyp formation. Whether there are some effective and economical routine inspection indicators for the early prediction and prevention of complications has clinical significance and is worth exploring.

A total of 592 newly diagnosed IBD patients [153 with ulcerative colitis (UC), 439 with Crohn's disease (CD)] were enrolled in a retrospective study. We compared the baseline characteristics (age at diagnosis, sex, clinical disease location and stage), serum C-reactive protein (CRP) level, serum erythrocyte sedimentation rate (ESR) level, total white blood cell (WBC), eosinophil (EOS) and platelet (PLT) counts for all IBD patients. And we evaluated the correlation between these routine parameters and the occurrence of clinical complications (including fistula, perforation, stricture, pseudopolyps or cancerous changes) in the course of IBD by univariate and multivariate analyses. Moreover, we constructed a dual parameter prediction system for complication's verification.

We demonstrated that higher serum CRP levels and total WBC counts independently indicated a higher hazard for the earlier occurrence of pseudopolyp formation in UC patients. Likewise, higher serum ESR and lower eosinophil count predicted the development of fistulas in CD patients, and higher serum ESR and PLT counts accounted for CD patients' strictures.

Novel predictive models including CRP level, ESR, WBC count, PLT and eosinophils were structured to predict complications in IBD, which might enable more aggressive treatment for patients at risk.