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Published on: October 16, 2013
Validation of disease severity index for predicting complicated disease in Crohn's disease: A comparison study with
Yun Qiu1, Longyuan Zhou1, Baolan Lu2
1Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China.
Insights
The Disease Severity Index (DSI) better predicts complicated Crohn's disease (CD) progression than the Lémann Index (LI). Higher DSI scores indicate a greater risk of severe outcomes in CD patients.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Inflammatory Bowel Disease Research
Background:
- The Disease Severity Index (DSI) is utilized for assessing bowel damage.
- Accurate assessment tools are crucial for managing Crohn's disease (CD) progression.
Purpose of the Study:
- To compare the efficacy of the Disease Severity Index (DSI) against the Lémann Index (LI) in predicting disease progression in high-risk Crohn's disease (CD) patients.
- To evaluate the DSI's ability to identify patients with a complicated disease course.
Main Methods:
- A retrospective review of 300 consecutive Crohn's disease (CD) patients treated between 2017 and 2019.
- Analysis included the Disease Severity Index (DSI), Lémann Index (LI), and occurrence of complicated CD.
- Statistical methods included Area Under the Curve (AUC) analysis and Cox proportional hazards modeling.
Main Results:
- The Disease Severity Index (DSI) demonstrated superior predictive ability (AUC 0.66) for complicated CD compared to the Lémann Index (LI) (AUC 0.56; P=0.007).
- Higher DSI scores (DSI>43), specific disease phenotypes (B2/3 vs. B1), and elevated C-reactive protein (CRP) were independent predictors of complicated CD.
- The Lémann Index (LI) was not significantly associated with complicated CD outcomes (P=0.164).
Conclusions:
- The Disease Severity Index (DSI) is a valuable tool for assessing disease severity and predicting outcomes in Crohn's disease (CD).
- DSI shows greater potential than LI in identifying CD patients at high risk for disease progression and complications.
Background:
Disease Severity Index (DSI) provides comprehensive assessment of bowel damage (BD).
Aims:
To evaluate DSI in patients with Crohn's disease (CD) at high risk of disease progression, compared to Lémann Index (LI).
Methods:
Patients with CD in our center were reviewed consecutively between 2017 and 2019. DSI, LI, and complicated CD course were analyzed.
Results:
The median LI and DSI of included 300 patients were 1.63 (IQR 1.25-3.13) and 42 (IQR 32-51), respectively. 152 patients (50.7%) experienced a complicated disease course (median 5.1 months; IQR 1.1-20.2). DSI (AUC 0.66; 95% CI 0.60-0.72) better predicted a complicated course of CD over LI (AUC 0.56; 95% CI 0.50-0.63; P = 0.007). The cumulative probability of complicated CD course in severe patients was higher than those with 'mild CD' (P < 0.001). The Cox analysis identified DSI>43 (HR 2.18; 95% CI 1.54-3.09; P < 0.001), B2/3 vs. B1 (HR 2.80; 95% CI 1.99-3.94; P < 0.001), and a higher level of CRP (HR 1.01; 95% CI 1.00-1.02; P = 0.005) as independent prognostic factors for complicated CD. However, LI was not associated with complicated CD (P = 0.164).
Conclusions:
Higher DSI was associated with complicated disease outcomes. DSI might play a better role than LI in identifying patients at high risks of disease progression.
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