Predictive factors of surgery in severe attacks of ulcerative colitis

ABSTRACT

The purpose of our study was to determine clinical, biological or endoscopic factors that predict surgery after a glucocortico steroid treatment failure in severe attacks of ulcerative colitis. Sixty one patients were analyzed. A therapeutic response for glucocorticosteroid was defined as the absence of resort to surgery within the first 30 days after hospitalization. Predictive factors were assessed using univariate and multivariate analysis. Fifteen patients [24,6%] had a medical response. In univariate analysis, predictive factors of surgery were male sex, tobacco, number of colitis attacks in case history, temperature over 38°C, ery-throcyte sedimentation rate over 30 mm, systolic blood pressure below 11, deep and wide ulcers. During the course, bowel movements/ day over 7, pulse over 90/mn, temperature over 38°C on day 3 after treatment initiation as well as passage of blood on day 5 were identified as predictors of surgery. In multivariate analysis, bowel movements over II day on day 3 of hospitalization was independently predicted a surgery. Bowel movements/ day over 7 on day 3 of hospitalization was the only independently predictive factor of surgery after glu-cortico steroid treatment failure