Restorative proctocolectomy for inflammatory bowel disease: The Padova prognostic score for colitis in predicting long-term outcome and quality of life

Marco Scarpa, Claudia Mescoli, Massimo Rugge, Renata D'Incà, Cesare Ruffolo, Lino Polese, Davide F. D'Amico, Giacomo C. Sturniolo, Imerio Angriman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In 10-20% of cases, it is impossible to distinguish between ulcerative colitis and Crohn's colitis, affecting the possibility to predict the long-term outcome after restorative proctocolectomy (RPC). The study aimed to assess the accuracy of a new prognostic score for inflammatory bowel diseases (IBD) colitis [the Padova Prognostic Score for Colitis (PPSC)] in predicting long-term clinical/functional outcome and quality of life after RPC. Materials and methods: The PPSC was created by the integration of histological and clinical information. The accuracy of the PPSC was tested in predicting long-term clinical outcome (i.e. pouch complications/survival) and quality of life of 58 consecutive patients who had undergone RPC in our institute from 1984 to 2004. Clinical outcome was assessed with an ad hoc functional questionnaire and the revision of the hospital and outpatients clinic notes. Quality of life surveys were carried out with the Padova IBD Quality of Life (PIBDQL) and with Cleveland Global Quality of Life (CGQL) scores. Results: The PPSC predicted pouch fistulae (accuracy = 84.5%; sensitivity = 50%; specificity = 90%) and changes in sexual life (accuracy = 71%; sensitivity = 23%; specificity = 87%). The PPSC also predicted the PIBDQL score with an accuracy of 62%, a sensitivity of 28% and a specificity of 97%, whilst it predicted the CGQL score with an accuracy of 29%, a sensitivity of 12% and a specificity of 80%. The PPSC failed to predict pouchitis or pouch failure. Conclusions: The Padova Prognostic Score for Colitis proved effective in predicting pouch fistulae or abscesses, but not pouchitis and pouch failure. The PPSC was accurate in predicting disease-specific quality of life.

Original languageEnglish
Pages (from-to)1049-1057
Number of pages9
JournalInternational Journal of Colorectal Disease
Volume24
Issue number9
DOIs
Publication statusPublished - 2009

Keywords

  • Crohn's colitis
  • Indeterminate colitis
  • Quality of life
  • Restorative proctocolectomy
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

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