Colitis: clinical findings helped predict patients who failed to improve on medical therapy.
Clinical bottom line (level 2b)
Around a quarter of patients admitted with acute proctocolitis failed to improve on medical therapy.
Patients with low albumin, high pulse rate or temperature and high stool frequency on admission were at increased risk of not responding to medical therapy.
Lennard-Jones et al:
Retrospective cohort study
for confounding factors,
validated in an independent set of patients.
Setting: acute hospital, UK
with 189 episodes of acute proctocolitis
admitted for investigation, assessment or elective surgery
medical therapy failure
Linear stepwise discriminant analysis was performed on the risk factors.
failure of medical therapy or immediate surgery required
||time to outcome
||number of patients/total number
| failure of medical therapy or immediate surgery required
- best combination of risk factors:
- maximum temperature or pulse rate (90 or more) on any day
- observed bowel frequency on day of admission (6 or more)
- serum albumin level (35 or less)
- No data was given to support the conclusions.
- This clinical prediction rule needs to be prospectively validated.
reference from review article
W, et al:
assessment of severity in colitis: a preliminary study.
Contributor: Chris Ball and Clare Wotton,
|Intervention or Exposure
||non-response to medical therapy