Predictive factors of glucocorticosteroid treatment failure in severe acute idiopathic colitis
Elloumi, H.; Ben Abdelaziz, A.; Derbel, F.; Jmaa, A.; Lassoued, Y.; Arfaoui, D.; Ben Ali, A.; Letaief, R.; Hamida, R.B.H.; Ghannem, H.; Ajmi, S.
Acta Gastro-Enterologica Belgica 68(2): 226-229
2005
ISSN/ISBN: 1784-3227 PMID: 16013638 Document Number: 592179
The purpose of our study was to determine clinical, biological or endoscopic factors that could predict glucocorticosteroid treatment failure in acute colitis. Fifty-four Tunisian Caucasian patients with acute idiopathic colitis (ulcerative colitis in 53 patients, Crohn's colitis in 1 patient) have been evaluated. Non-therapeutic response was defined as over 6 bowel movements per day, blood visible to the naked eye in stools on the fifth day after admission or the development of a complication inducing a resort to surgery. Predictive factors were assessed using bivariate and multivariate analysis. Thirty-nine patients (72.2%) had no medical response. In univariate analysis, predictive factors of therapeutic failure were: male sex, tobacco, previous history of colitis attacks, bowel movements per day over seven at admission and on day three, and pulse rate over 90/mn, temperature over 38 degrees C, systolic blood pressure below 11 on day 3 and on day 5 after admission. In multivariate analysis, bowel movements over seven per day on day 3 of hospitalization and male sex independently predicted a failure of glucorticosteroid treatment. Bowel movements per day over seven on day 3 of hospitalization and male sex were the independently predictive factors of failure of glucocorticosteroid treatment.