Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn's Disease

Lucrezia Laterza, Anna Chiara Piscaglia, Laura Maria Minordi, Iolanda Scoleri, Luigi Larosa, Andrea Poscia, Fabio Ingravalle, Arianna Amato, Sergio Alfieri, Alessandro Armuzzi, Giovanni Cammarota, Antonio Gasbarrini, Franco Scaldaferri

Research output: Contribution to journalArticle

Abstract

Aim: To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn's disease (CD). Methods: We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively. Hospitalizations, surgery, therapeutic changes and deaths were evaluated up to 36 months (time 1) for 53 patients. Results: CTE and endoscopy agreed in stratifying disease activity in 47% of cases (k = -0.05; p = 0.694), CTE and HBi in 35% (k = 0.09; p = 0.08), endoscopy and HBi in 39% (k = 0.13; p = 0.03). Taken together, CTE, endoscopy and HBi agreed only in 18% of cases (k = 0.01; p = 0.41). Among the 11 cases with mucosal healing, only 3 (27%) showed transmural healing. Patients with endoscopic activity needed significantly more changes of therapy compared to patients with endoscopic remission (p = 0.02). Patients with higher transmural or clinical activity at baseline required significantly more hospitalizations (p < 0.01). Hospitalization rate decreases with an increase in the number of parameters indicating remissions at baseline (p = 0.04). Conclusions: Clinical, endoscopic and radiological assessments offer complementary information and could predict different mid-term outcomes in CD.

Original languageEnglish
Pages (from-to)184-193
Number of pages10
JournalDigestive Diseases
Volume36
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

    Fingerprint

Keywords

  • Crohn's disease
  • CT-enterography
  • Endoscopy
  • Inflammatory bowel disease
  • Prognosis
  • Recurrence

ASJC Scopus subject areas

  • Gastroenterology

Cite this