Title: Comparing HO and Travis Criteria in Acute Severe Ulcerative Colitis – In a Tertiary Care Centre, South India
Authors: L. Sujatha, Caroline Selvi, Premkumar, A. Chezhian, R. Murali
DOI: https://dx.doi.org/10.18535/jmscr/v9i4.14
Abstract
Aim: To compare Ho score with Travis score in predicting steroid responsiveness in acute severe ulcerative colitis.
Methods and Material: Our study is a prospective observational study including all patients who got admitted in Institute of medical gastroenterology, Rajiv Gandhi Government General Hospital, Chennai, between January 2019 and December 2019 with acute severe ulcerative colitis as per True love witts score.
Results: Among 64, 55 were male and 9 were female. Mean age of patients is 32 years (range 16-45 years). Day 3 Travis score was high in 16 patients (25%) and low in 48 patients (75%). 48 patients (75%) were steroid responsive and 16 patients (25%) were steroid non-responsive who received second line therapy in the form of anti-TNF agents. All 4 patients with high Ho score on day 3 were steroid non-responders, 6 patients with intermediate Ho score were steroid responsive and 12 patients with intermediate Ho score on day 3 were steroid non-responders. Ho score of > 2.5 has sensitivity of 62.5% and specificity of 100% in predicting steroid responsiveness.
Conclusion: We conclude that in acute severe ulcerative colitis, patients with high Travis or the Ho scores are more likely to be resistant to IV steroids. In anti-TNF era, the risk of surgery in those high risk patients is lower than previously reported.
Keywords: Acute severe ulcerative colitis, Travis score, Ho score, steroid refractory ulcerative colitis
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