P321 Increased modified DUBLIN scores are associated with serious ulcerative colitis and treatment failure

Xie, C.(1)*;Su, J.(1);Liu, L.(1);Lin, Y.(1);Hu, Y.(1);Shi, H.(1);

(1)Zhongshan Hospital Affiliated to Xiamen University, Gastroenterology, Xiamen, China;

Background

Grading of endoscopic lesions is important for determining the severity of ulcerative colitis and developing treatment strategies, but the commonly used methods are not sufficient.This study aimed to investigate whether new endoscopic scoring systems incorporating lesions and disease extent are associated with clinical disease severity and maintainable remission.

Methods

This was a retrospective study. One hundred and ten patients with ulcerative colitis were included and eighty seven completed 12 months follow-up.Colonoscopy was performed within 1 week before blood samples were taken. DUBLIN (Degree of ulcerative colitis burden of luminal inflammation) scores were calculated as the product of MES (Mayo endoscopic score) by disease extent and UCEIS (ulcerative colitis endoscopic index of severity) was used to replace MES when calculating modified DUBLIN scores.

Results

DUBLIN and modified DUBLIN scores were increased in the moderate and severe groups significantly (p<0.05). Both of increased scores contributed to the detection of serious diseases, and the clinical cut-off values of DUBLIN and modified DUBLIN were 3(AUC=0.809, p=0.001) and 7(AUC=0.815, p=0.001). They were with high sensitivity, but the specificity of DUBLIN was lower. Both scores were correlated to partial Mayo scores, CPR and ESR positively, and they were correlated to the albumin negatively (p<0.05). Higher modified DUBLIN scores (>7) were associated with an increase risk of treatment failure (HR=4.96, 95% CI 1.17-21.00, p=0.03), but there were no association between DUBLIN scores and long term remission (p>0.05).






Conclusion

Increased DUBLIN and modified DUBLIN scores were conducive to screening serious disease, but only modified DUBLIN scores had the potential to assist in making an upgraded therapeutic schedule.