Comparison of The Toronto IBD Global Endoscopic Reporting (TIGER) score, Mayo endoscopic score (MES), and ulcerative colitis endoscopic index of severity (UCEIS) in predicting the need for ileal pouch–anal anastomosis in patients with ulcerative colitis

Xu, Weimin; Liu, Fangyuan; Hua, Zhebin; Gu, Yubei; Lian, Lei; Cui, Long; Ding, Zhao; Du, Peng

doi:10.1007/s00384-023-04347-3

Cited by 2 publications

(1 citation statement)

References 46 publications

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“… 27 Although MES is still the most commonly used score in clinical practice, our results on MES performance come at no surprise, being in line with previous reports. 28 In addition, since IUS is easily repeatable sequential examinations can be of greater benefit than a single timepoint assessment. The variable timeframe between colonoscopy and IUS may limit our conclusions, as in a recent study BWT assessed by IUS had changed as early as within 48 h after intravenous steroids in patients with Acute Severe Ulcerative Colitis (ASUC).…”

Section: Discussionmentioning

confidence: 99%

Superior predictive value of transmural over endoscopic severity for colectomy risk in ulcerative colitis: a multicentre prospective cohort study

Piazza O Sed,

Noviello,

Filippi

et al. 2023

Journal of Crohn's and Colitis

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Background and Aims Endoscopic activity is associated with an increased risk of surgery in patients with ulcerative colitis (UC). Transmural activity, as defined by Milan Ultrasound Criteria (MUC) >6.2, reliably detects endoscopic activity in patients with UC. The study aimed to assess in UC patients whether transmural severity is a better predictor of colectomy as compared to endoscopy. Methods Consecutive adult UC patients were recruited in two IBD Referral Centers and underwent colonoscopy and intestinal ultrasound in a blinded fashion. The need for colectomy was assessed at follow-up. Univariable and multivariable logistic and Cox regression analyses were performed. ROC analysis was used to compare MUC baseline values and Mayo Endoscopic Scores (MES) in predicting colectomy risk. Results Overall, 141 patients were enrolled, and 13 underwent colectomy in the follow-up period. Both MES (HR: 3.15, 95% CI: 1.18–8.37, p=0.02) and MUC (HR: 1.48, 95% CI: 1.19–1.76, p <0.001) were associated with colectomy risk, but only MUC was independently associated with this event at multivariable analysis (HR: 1.46, 95% CI: 1.06–2.02, p=0.02). MUC was the only independent variable associated with colectomy risk in patients with clinically active disease, OR: 1.53 (1.03–2.27) P=0.03. MUC demonstrated higher accuracy than MES (AUROC 0.83, 95% CI: 0.75–0.92 vs. 0.71 95% CI: 0.62–0.80) and better performance for predicting colectomy (p=0.02). The optimal MUC score cut-off value for predicting colectomy, as assessed by the Youden index, was 7.7. Conclusions A superior predictive value was found for transmural versus endoscopic severity for colectomy risk in UC patients.

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Section: Discussionmentioning

confidence: 99%

Superior predictive value of transmural over endoscopic severity for colectomy risk in ulcerative colitis: a multicentre prospective cohort study

Piazza O Sed,

Noviello,

Filippi

et al. 2023

Journal of Crohn's and Colitis

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Clinical value of the Toronto inflammatory bowel disease global endoscopic reporting score in ulcerative colitis

Liu,

Tian,

Zhang

et al. 2023

World J Gastroenterol

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BACKGROUND Endoscopic evaluation in diagnosing and managing ulcerative colitis (UC) is becoming increasingly important. Several endoscopic scoring systems have been established, including the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score and Mayo Endoscopic Subscore (MES). Furthermore, the Toronto Inflammatory Bowel Disease Global Endoscopic Reporting (TIGER) score for UC has recently been proposed; however, its clinical value remains unclear. AIM To investigate the clinical value of the TIGER score in UC by comparing it with the UCEIS score and MES. METHODS This retrospective study included 166 patients with UC who underwent total colonoscopy between January 2017 and March 2023 at the Affiliated Hospital of Qingdao University (Qingdao, China). We retrospectively analysed endoscopic scores, laboratory and clinical data, treatment, and readmissions within 1 year. Spearman’s rank correlation coefficient, receiver operating characteristic curve, and univariate and multivariable logistic regression analyses were performed using IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, United States) and GraphPad Prism version 9.0.0 for Windows (GraphPad Software, Boston, Massachusetts, United States). RESULTS The TIGER score significantly correlated with the UCEIS score and MES (r = 0.721, 0.626, both P < 0.001), showed good differentiating values for clinical severity among mild, moderate, and severe UC [8 (4–112.75) vs 210 (109–219) vs 328 (219–426), all P < 0.001], and exhibited predictive value in diagnosing patients with severe UC [area under the curve (AUC) = 0.897, P < 0.001]. Additionally, the TIGER (r = 0.639, 0,551, 0.488, 0.376, all P < 0.001) and UCEIS scores (r = 0.622, 0,540, 0.494, and 0.375, all P < 0.001) showed stronger correlations with laboratory and clinical parameters, including C-reactive protein, erythrocyte sedimentation rate, length of hospitalisation, and hospitalisation costs, than MES (r = 0.509, 0,351, 0.339, and 0.270, all P < 0.001). The TIGER score showed the best predictability for patients' recent advanced treatment, including systemic corticosteroids, biologics, or immunomodulators (AUC = 0.848, P < 0.001) and 1-year readmission (AUC = 0.700, P < 0.001) compared with the UCEIS score (AUC = 0.762, P < 0.001; 0.627, P < 0.05) and MES (AUC = 0.684, P < 0.001; 0.578, P = 0.132). Furthermore, a TIGER score of ≥ 317 was identified as an independent risk factor for advanced UC treatment (P = 0.011). CONCLUSION The TIGER score may be superior to the UCIES score and MES in improving the accuracy of clinical disease severity assessment, guiding therapeutic decision-making, and predicting short-term prognosis.

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Comparison of The Toronto IBD Global Endoscopic Reporting (TIGER) score, Mayo endoscopic score (MES), and ulcerative colitis endoscopic index of severity (UCEIS) in predicting the need for ileal pouch–anal anastomosis in patients with ulcerative colitis

Cited by 2 publications

References 46 publications

Superior predictive value of transmural over endoscopic severity for colectomy risk in ulcerative colitis: a multicentre prospective cohort study

Superior predictive value of transmural over endoscopic severity for colectomy risk in ulcerative colitis: a multicentre prospective cohort study

Clinical value of the Toronto inflammatory bowel disease global endoscopic reporting score in ulcerative colitis

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