Nakarai A, Kato J, Hiraoka S, Inokuchi T, Takei D, Moritou Y, Akita M, Takahashi S, Hori K, Harada K, Okada H, Yamamoto K. Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing, which can be predicted from the platelet count. World J Gastroenterol 2014; 20(48): 18367-18374 [PMID: 25561804 DOI: 10.3748/wjg.v20.i48.18367]
Corresponding Author of This Article
Sakiko Hiraoka, MD, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. sakikoh@cc.okayama-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 28, 2014; 20(48): 18367-18374 Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18367
Table 1 Baseline characteristics of analyzed patients n (%)
Patients
Value
Total
183
Gender
Male
93 (51)
Female
90 (49)
Extent of disease
Pancolitis
112 (61)
Left-side colitis
40 (22)
Proctitis
31 (17)
Median (IQR) age at onset
32 (22-45)
Median (range) duration of disease, mo
108 (54-202)
Median (range) age of undergoing colonoscopy
44 (33-59)
Concomitant medications
Aminosalicylate
163 (89)
Corticosteroids
23 (13)
Mercaptopurine/azathioprine
70 (38)
Tacrolimus
5 (3)
Biologics
7 (4)
Colonoscopy findings (maximum index in the colorectum)
MES 0
80 (44)
MES 1
89 (48)
MES 2
14 (8)
Table 2 Characteristics of patients with Mayo endoscopic subscore 0 vs 1 or 2 n (%)
Characteristics
MES 0 (n = 80)
MES 1, 2 (n = 103)
P value
Gender
Male
45 (56)
48 (47)
0.2
Female
35 (44)
55 (53)
Median age, yr (IQR)
49 (37-62)
40 (32-54)
0.009
Median duration of disease, mo (IQR)
98 (52-213)
122 (57-202)
0.73
Median age at onset, yr (IQR)
36 (25-50)
29 (19-40)
0.009
Extent of disease
Pancolitis
42 (53)
70 (68)
0.1
Left-side colitis
21 (26)
19 (18)
Proctitis
17 (21)
14 (14)
Concomitant medications
Aminosalicylate
72 (90)
91 (88)
0.72
Corticosteroids
12 (15)
11 (11)
0.38
Mercaptopurine/azathioprine
28 (35)
42 (41)
0.43
Tacrolimus
3 (4)
2 (2)
0.46
Biologics
2 (3)
5 (5)
0.41
Blood markers, median (IQR)
CRP (mg/L)
0.4 (0.2-1.0)
0.5 (0.2-1.2)
0.3
WBC (/μL)
5160 (4130-5990)
5660 (4830-6800)
0.017
Hb (g/dL)
13.6 (12.4-15.0)
13.5 (12.4-14.7)
0.75
PLT (× 104/μL)
24.7 (21.7-27.6)
29.1 (25.6-33.4)
< 0.0001
Alb (g/dL)
4.5 (4.2-4.8)
4.4 (4.1-4.7)
0.17
Table 3 Univariate and multivariate analysis for factors predictive of Mayo endoscopic subscore 0
OR
Univariate analysis95%CI
P value
OR
Multivariate analysis95%CI
P value
Age > 48 yr
2.59
1.42-4.78
0.002
1.88
0.79-4.52
0.15
Age at onset > 32 yr
2.39
1.32-4.38
0.004
1.46
0.61-3.46
0.39
WBC < 5900/μL
2.65
1.43-5.05
0.002
2.37
1.19-4.81
0.014
PLT < 26 × 104/μL
4.74
2.55-9.01
< 0.0001
4.10
2.15-7.99
< 0.0001
Table 4 Predictive values of white blood cell and platelet count for Mayo endoscopic subscore 0 in patients with sustained clinical remission
WBC < 5900/μLonly
PLT < 26 × 104/μLonly
Either WBC < 5900/μL or PLT < 26 × 104/μL
Both WBC < 5900/μL and PLT < 26 × 104/μL
Sensitivity (95%CI)
0.74 (0.66-0.81)
0.65 (0.57-0.72)
0.91 (0.85-0.95)
0.48 (0.40-0.54)
Specificity (95%CI)
0.49 (0.42-0.54)
0.72 (0.66-0.77)
0.39 (0.34-0.42)
0.82 (0.76-0.87)
Table 5 Change in blood marker values in patients with or without maintenance of complete mucosal healing n (%)
Variables
Maintenance of MES 0 (n = 26)
Shift to MES 1 (n = 21)
P value
Extent of disease
Pancolitis
13 (50)
13 (62)
Left-side colitis
10 (38)
3 (14)
Proctitis
3 (12)
5 (24)
0.15
Median (IQR) age at onset
36 (27-49)
28 (23-43)
0.2
Median (range) duration of disease, mo
132 (55-220)
152 (64-244)
0.65
Change in values of parameters
median (IQR)
ΔCRP (mg/L)
0.1 (-0.1-0.4)
0 (0.2-0.4)
0.95
ΔWBC (/μL)
-200 (-1680-780)
280 (-330-1030)
0.16
ΔHb (g/dL)
0.1 (-0.3-0.8)
0.4 (-0.1-0.8)
0.25
ΔPLT (× 104/μL)
-0.6 (-2.4-1.5)
3.8 (1.5-8.0)
< 0.0001
ΔAlb (g/dL)
0.1 (-0.2-0.3)
0 (-0.1-0.2)
0.82
Citation: Nakarai A, Kato J, Hiraoka S, Inokuchi T, Takei D, Moritou Y, Akita M, Takahashi S, Hori K, Harada K, Okada H, Yamamoto K. Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing, which can be predicted from the platelet count. World J Gastroenterol 2014; 20(48): 18367-18374