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P227 Lower serum albumin level on admission is a predictive factor of colectomy in patients with moderate to severe ulcerative colitis

M. Tanaka*, Y. Hotta, K. Uchiyama, T. Takagi, Y. Naito

Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Department of Molecular Gastroenterology and Hepatology, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan

Background

Little is known about the predictive factor of later colectomy in patients with moderate to severe ulcerative colitis (UC). We aimed to identify the factors which predict colectomy in patients with mild to severe ulcerative colitis on admission.

Methods

This retrospective study used the data from the clinical database, including a cohort of 51 patients with moderate to severe UC who received induction therapy at a single center, Kyoto Prefectural University of Medicine between 2008 and 2014. Clinical parameters (age, sex, disease extent, and disease activity (CAI: Lichtiger index) on admission) and laboratory data (hemoglobin, albumin, C-reactive protein, and cytomegalovirus reactivation on admission) were evaluated in 51 patients. The clinical difference between cases to achieve remission and the colectomy were evaluated.

Results

31 of 51 cases were achieved in the remission by induction therapy. The colectomy was performed in 20 of 51cases. Clinical parameters such as age, sex, disease extent, and disease activity on admission showed no difference between two groups (remission group and colectomy group). In laboratory data, only the lower levels of albumin on admission were the most significant predictors of the later colectomy [OR=0.213 95%CI=0.075-0.603)]. The patients with under 2.5g/dl of serum albumin on admission, 62.5% (15/24) cases were performed colectomy, in contrast, 15% (3/20) cases with over 2.5g/dl.

Conclusion

In this study, the serum albumin level on admission was the most important predictive factor for colectomy in patients with moderate to severe ulcerative colitis