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Poster presentations: Clinical: Diagnosis and Outcome 2020

P270 Ulcerative colitis disease extent and inflammatory burden assessment: DUBLIN and modified Nancy score

J.C. Rocha Silva1, J. Rodrigues2, A. Rodrigues2, A. Silva2, C. Fernades2, A. Sousa3, M. Sousa3, A.C. Gomes2, E. Afeto2, J. Carvalho2

1Centro Hospitalar Vila Nova de Gaia e Espinho, Gastroenterology, Vila Nova Gaia, Portugal, 2Centro Hospitalar Vila Nova de Gaia/Espinho, Gastroenterology, Vila Nova de Gaia, Portugal, 3Centro Hospitalar de Vila Nova de Gaia e Espinho, Gastroenterology, Vila Nova de Gaia, Portugal

Background

Current endoscopic activity scores for ulcerative colitis (UC) do not take into account the extent of mucosal inflammation. The DUBLIN score (Degree of Ulcerative Colitis Burden of Luminal Inflammation) is a simple bedside clinical score that estimates inflammatory burden using both disease severity and extent, which correlates with objective inflammatory markers and is associated with clinical outcomes. The validated Nancy score is used to evaluate histological activity; nonetheless, it does not take in consideration disease extension. We aimed to evaluate the relation of both Mayo and Dublin scores with disease activity and as predictive factors of clinical relapse. Also, we developed a modified Nancy score in order to assess histologic activity considering disease extension.

Methods

A retrospective cohort study, which consecutively included all UC patients submitted to colonoscopy with biopsies between 2016 and 2019 in our unit. Mayo and DUBLIN scores were calculated. Modified Nancy score was calculated as a product of Nancy Score and disease extent (E1-E3). Correlation of both endoscopic and histologic scores with biomarkers, relapse (in a 6months) and relapse-free time as performed.

Results

107 patients were selected, 52.3% (n = 56) male, mean age = 48.4 ± 13.9 years. Mean Dublin score was 2.65 ± 2.75. Mayo and DUBLIN scores presented good correlation (r = 0.880, p < 0.001). Also Dublin score correlated with modified Nancy score (p < 0.001). Both Dublin score (p = 0.009) and modified Nancy score (p = 0.026) correlated with C-reactive protein levels. Nancy score correlated with faecal calprotectin (p = 0,025).

Relapse occurred in 26.2% (n = 28) of patients with a mean time for the event of 13 ± 7 weeks. Mayo Score (p < 0.001), Dublin score (p < 0.001), Nancy score (p < 0.001) and modified Nancy score (p < 0.001) presented a significant association with relapse. Areas under the ROC curve were 0.786 for Dublin score, 0.751 for Mayo score, 0.84 for Nancy score and 0.79 for modified Nancy score.

Conclusion

DUBLIN and modified Nancy scores correlate with each other and with biomarkers and are independent predictors of relapse. Dublin score was superior to Mayo score in the prediction of relapse.