P278 Endoscopic scoring system utilization for Inflammatory Bowel Disease activity assessment: a multicenter real-world evidence study from Argentina (DARE study)
Lasa, J.(1)*;Martínez, S.(1);Smolarczuk, A.(2);Navar, S.(2);Espinosa, F.(2);Pereyra, L.(2);Rainero, G.(3);Meligrana, N.(3);Marturano, V.(4);Steinberg, L.(5);Reyes, K.(5);Giraudo, F.(6);Garbi, L.(6);Gullino, L.(6);Yantorno, M.(6);Correa, G.(6);Ponce, C.(2);Orellana, D.(7);Galvarini, M.(7);Caruso, E.(7);Olivera, P.(8);
(1)CEMIC, Gastroenterology Department, Buenos Aires, Argentina;(2)Hospital Alemán, Gastroenterology Department, Buenos Aires, Argentina;(3)Hospital Universitario Austral, Gastroenterology Department, Pilar, Argentina;(4)Hospital Durand, Gastroenterology Department, Buenos Aires, Argentina;(5)Hospital Universitario Fundación Favaloro, Gastroenterology Department, Buenos Aires, Argentina;(6)Hospital San Martín, Gastroenterology Department, La Plata, Argentina;(7)Hospital Alemán, Gastroenterology, Buenos Aires, Argentina;(8)Zane Cohen Centre for Digestive Diseases- Lunenfeld-Tanenbaum Research Institute- Sinai Health System, Gastroenterology, Toronto, Canada;
Background
The use of scores for the assessment of endoscopic activity in inflammatory bowel disease (IBD) patients is crucial for accurate and reproducible evaluation of mucosal healing, which is a relevant marker of prognosis. Frequency and patterns of their use in a real-life setting are not known. We aimed to describe the prevalence of adequate use of endoscopic scores in IBD patients who underwent colonoscopy in a real-life setting.
Methods
A multicenter observational study comprising six community hospitals in Argentina was undertaken. Patients with a diagnosis of Crohn’s disease or ulcerative colitis who underwent colonoscopy for endoscopic activity assessment between July 2018 and July 2022 were included. Colonoscopy reports of included subjects were manually reviewed to determine the proportion of colonoscopies that included an endoscopic score report. We compared the endoscopic findings to determine if there were differences in the score reported and the inflammatory activity described. Finally, we determined the proportion of colonoscopy reports that included all of the IBD colonoscopy report quality elements proposed by BRIDGe group. Endoscopist’s specialty, years of experience as well as expertise in IBD were assessed. Chi square test was used for the comparison of categorical variables; Student t test for the comparison of numerical variables. A multivariate analysis was performed using a logistic regression model. A p value of less than 0.05 was considered to be statistically significant.
Results
A total of 1206 patients were included for analysis (32.25% patients with Crohn’s disease). Mean age was 45.48±15.6. Endoscopic score reporting was found in only 34.45% of Crohn’s disease colonoscopies and in 52.87% of ulcerative colitis colonoscopies. Most frequently used scores were Mayo endoscopic score (90.56%) and SES-CD (56.03%).
We found discrepancies between the score reported and the findings described in colonoscopies in 10.92% of cases; only 26% of reports included all recommendations proposed by BRIDGe group. On multivariate analysis, surgeons as operators [OR 0.08 (0.03-0.18)], >15 years of endoscopist experience [OR 0.24 (0.07-0.37)], IBD expertise [OR 2.86 (1.86-4.41)] and compliance of quality elements of reporting [OR 2.48 (1.24-3.76)] were significantly associated with endoscopic score reporting.
Conclusion
We identified a low prevalence of endoscopic activity score reporting in IBD patients’ colonoscopies. This finding is associated with operator-dependent characteristics. Educational interventions can be introduced to increase adequate score reporting.