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Article Dans Une Revue European Radiology Année : 2022

Development and validation of a composite score to predict severe forms of ischemic colitis

Résumé

Objective: To develop a simple scoring system in order to predict the risk of severe (death and/or surgery) ischemic colitis METHODS: In this retrospective study, 205 patients diagnosed with ischemic colitis in a tertiary hospital were consecutively included over a 6-year period. The study sample was sequentially divided into a training cohort (n = 103) and a validation cohort (n = 102). In the training cohort, multivariable analysis was used to identify clinical, biological, and CT variables associated with poor outcome and to build a risk scoring system. The discriminative ability of the score (sensitivity, specificity, positive predictive value, negative predictive value) was estimated in the two cohorts to externally validate the score, and a receiver operating characteristic curve was established to estimate the area under the curve of the score. Bootstrapping was used to validate the score internally. Results: In the training cohort, four independent variables were associated with unfavorable outcome: hemodynamic instability (2 pts), involvement of the small bowel (1 pt), paper-thin wall pattern (3 pts), no stratified enhancement pattern (1 pt). The score was used to categorize patients into low risk (score: 0, 1), high risk (score: 2-3), and very high risk (score: 4-7) groups with sensitivity and specificity of 97% and 67%, respectively, and a good discriminating capability, with a C-statistic of 0.94. Internal and external validation showed good discrimination capability (C-statistics of 0.9 and 0.84, respectively). Conclusion: A simple risk score can stratify patients into three distinct prognosis groups, which can optimize patient management.
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Dates et versions

hal-04107746 , version 1 (26-05-2023)

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Citer

Quentin Fillias, Ingrid Millet, Boris Guiu, Céline Orliac, Fernanda Curros-Doyon, et al.. Development and validation of a composite score to predict severe forms of ischemic colitis. European Radiology, 2022, 32 (9), pp.6355-6366. ⟨10.1007/s00330-022-08726-2⟩. ⟨hal-04107746⟩

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