Chinese research into severe ulcerative colitis has increased in quantity and complexity

Luo, Cheng-Xin; Wen, Zhong-Hui; Zhen, Yu; Wang, Zhu-Jun; Mu, Jing-Xi; Zhu, Min; Ouyang, Qin; Zhang, Hu

Our publication search retrieved 8 original research articles focused on surgical management in SUC patients, in which 200 SUC patients who received surgical intervention were studied. Two articles investigated the predictors for the need for colectomy, using the Oxford index, Swedish index, Edinburgh index, and Seo index [21] . The Oxford index, also known as the Travis index, was developed in 1996 and has been validated in cohort studies. According to this index, patients with a stool frequency of more than 8 per day, or 3-8 stools per day plus an elevated CRP (> 45 mg/L) at day 3 of corticosteroid therapy, have a 85% chance of colectomy. The Swedish index is calculated using the algorithm: "number of stools per day + 0.14 x CRP (mg/L)", with scores > 8 indicating a high risk of requiring colectomy. The Edinburgh index is also known as the Ho score, in which scores for stool frequency (1-4 points), hypoalbuminemia < 3 mg/dL (1 point) and radiological evidence of colonic dilation (4 points) are summed, and scores greater than 4 are predictive for failure of corticosteroid therapy and subsequent need for colectomy. The Seo index is calculated using the mathematical formula: "60 x frequency of bloody stool + 13 x bowel movements + 0.5 x ESR (mm/h) -4 x hemoglobin (g/dL) -15 x albumin (g/dL) + 200"; where scores greater than 200 predicting the need for colectomy. These 2 articles reported that the either the Oxford and Swedish indices are superior to the Edinburgh and Seo indices in predicting medical failure and the subsequent need for surgical intervention.