Role of surgery in severe ulcerative colitis in the era of medical rescue therapy

Table 1 Prediction rules for corticosteroid failure in patients with acute severe ulcerative colitis

Prediction rule	Study	Measure	Prediction accuracy
Oxford index	Travis et al[12], prospective; Turner et al[10], retrospective	Stool frequency of > 8/d or 3-8/d and CRP > 45 mg/L (on day 3 of IVCS)	Adults: PPV = 85% Children: Sens = 38%, Spec = 100%, PPV = 88%, NPV = 75%
Swedish index (the fulminant colitis index)	Lindgren et al[13], retrospective; Järnerot et al[18], prospective; Turner et al[10], retrospective	CRP mg/L × 0.14 + daily stool frequency (cutoff > 8 on day 3 of IVCS)	Adults: Sens = 78%, Spec = 81%, PPV = 69%-72% Children: Sens = 64%, Spec = 92%, PPV = 88%, NPV = 75%
Seo index	Seo et al[15], retrospective; Turner et al[10], retrospective	60 × bloody stool + 13 × bowel movements + 0.5 × ESR - 4 × Hb - 15 × albumin + 200	Adults (cutoff > 180 on day 7 of IVCS): PPV = 52%, NPV = 97% Children: (cutoff > 240 on day 5 of IVCS): Sens = 27%, Spec = 93%, PPV = 80%, NPV = 56%
Scottish index	Ho et al[14], prospective	The score (0-9) includes: stool frequency, presence of colonic dilatation, and albumin level (cutoff > 4 on day 3 of IVCS)	Adults: Sens = 85%, Spec = 75%
PUCAI	Turner et al[10], retrospective; Turner et al[17], prospective	The score (0-85) includes: stool frequency and consistency, presence of blood, nocturnal stools, activity level, and abdominal pain	Children: PUCAI > 45 on day 3 of IVCS: Sens = 92%-93%, NPV = 88%-94% PUCAI > 70 on day 5: Sens = 35%-44%, Spec = 93%-100%, PPV = 87%-100%, NPV = 63%-79%

NPV: Negative predictive value; PPV: Positive predictive value; Hb: Hemoglobin; ESR: Erythrocyte sedimentation rate; IVCS: Intravenous corticosteroids; Spec: Specificity; Sens: Sensitivity; CRP: C-reactive protein; PUCAI: Pediatric Ulcerative Colitis Activity Index.