Early intestinal ultrasound in severe ulcerative colitis identifies patients at increased risk of 1-year treatment failure and colectomy
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View abstract on PubMed
Summary
This summary is machine-generated.Intestinal ultrasound (IUS) can predict colectomy risk in severe ulcerative colitis (UC) patients. Bowel wall thickness at 48 hours indicates higher risk for surgery and aggressive disease course.
Area Of Science
- Gastroenterology
- Medical Imaging
- Inflammatory Bowel Disease Research
Background
- Severe ulcerative colitis (UC) lacks reliable objective markers for predicting long-term treatment outcomes.
- Current treatment strategies for severe UC often rely on clinical assessments that may not fully capture disease activity.
Purpose Of The Study
- To evaluate if intestinal ultrasound (IUS) can predict long-term outcomes in hospitalized severe UC patients treated with intravenous corticosteroids.
- To identify objective markers for disease activity and treatment response in severe UC.
Main Methods
- Hospitalized severe UC patients with IUS-defined inflammation (bowel wall thickness [BWT] >3.0mm) receiving IV corticosteroids were recruited.
- IUS assessments were performed pre-treatment, at 48±24 hours, 6±1 days, and 3 months.
- Outcomes measured included time to colectomy or intervention, Mayo score at 3 months, and partial Mayo score (pMayo) at 12 months over a 12-month follow-up.
Main Results
- Forty-five of 56 patients (80%) required intervention, including 9 colectomies.
- A BWT <3mm at 48 hours predicted no need for colectomy (p=0.04).
- BWT ≥4mm at 48 hours indicated increased risk for colectomy (OR 9.5) and shorter time to colectomy and treatment intensification.
- Neither IUS parameters nor clinical markers predicted remission at 3 or 12 months.
Conclusions
- Bowel wall thickness (BWT) measured by IUS 48 hours after initiating IV corticosteroids can identify severe UC patients at higher risk for colectomy.
- IUS-assessed BWT may predict a more aggressive short-term disease course in hospitalized severe UC patients.
- IUS shows potential as an objective tool for guiding treatment decisions in severe UC.
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