PREDICTORS OF COLECTOMY IN PATIENTS WITH «EXTREMELY SEVERE» ULCERATIVE COLITIS

Abstract

AIM: to identify predictors of colectomy in patients with «extremely severe» ulcerative colitis.PATIENTS AND METHODS: seventy-four patients with severe ulcerative colitis in 2017 were included in the study. The patients were divided into the groups of colectomy (54 pts) and conservative treatment (20 pts).The predictors such as serum albumin, C-reactive protein, hemoglobin, endoscopic picture, and clinical data were analyzed.RESULTS: the groups were homogeneous by gender, age and duration of the disease. Mean albumin and hemoglobin levels were significantly lower (28 g/l and 96 g/l) in the colectomy group.The endoscopic picture of «extensive ulcer defects merging among themselves» was significantly more common in the operated patients – 78%, compared with 5% in the conservative treatment group (p<0.0001). The risk of colectomy in the presence of an endoscopic picture was 85%, and when combined with an albumin level of less than 31 g/l and hemoglobin of less than 107 g/l, the risk increased to 100%.CONCLUSION: the endoscopic picture of «extensive, merging ulcerative defects» in combination with an albumin level of less than 31 g/l and hemoglobin less than 107 g/l are predictors of colectomy with high predictive value.