Prospective validation of AIIMS index as a predictor of steroid failure in patients with acute severe ulcerative colitis

Letter: ‘No first among equals’—Authors' reply

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We thank Dr. Arora et al for their letter 1 in response to our systematic review on scores used to predict outcomes in acute severe ulcerative colitis (ASUC), and appreciate the additional information regarding their excellent work in developing and validating the AIIMS index. [2][3][4] We agree the Lichtiger index is a valuable tool for the diagnosis of ASUC and assessment of steroid failure. However, since it cannot be used to predict outcomes in ASUC, it was not included in our systematic review.There are two major limitations to the use of currently available scores.

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Editorial commentary on the Indian Journal of Gastroenterology—May–June 2022

“…Among 39 patients admitted with ASUC, 15 (38%) failed IV steroids and required rescue therapy. On multivariate analysis, a day 3 FCP >1000 μg (OR 6.2) and baseline UCEIS ≥7 (OR 10.1) were independent predictors of steroid failure and need for rescue therapy [15]. The AIIMS index predicted steroid failure with better specificity and positive predictive values than the Oxford criteria.…”

“…In this issue of the Indian Journal of Gastroenterology, Sahu and colleagues from All India Institute of Medical Sciences, New Delhi, India, present a validation study for the previously reported AIIMS index, as a predictor of steroid failure in patients with ASUC [14,15]. A UCEIS ≥7 at admission and fecal calprotectin (FCP) >1000 μg were independent predictors of steroid failure [14].…”

Predictors of adverse outcomes of steroids in patients with severe ulcerative colitis (systematic review and meta-analyses)

“…6). [11] 2017 124 Альбумин, С-реактивный белок Xie et al [12] 2017 117 Альбумин, С-реактивный белок, гемоглобин, эндоскопическая картина Jain et al [13] 2017 49 Альбумин, С-реактивный белок, гемоглобин, эндоскопическая картина Choy et al [14] 2018 54 Альбумин, С-реактивный белок, гемоглобин, эндоскопическая картина Xie (2) et al [15] 2018 92 Альбумин, эндоскопическая картина Dalal et al [16] 2019 440 Альбумин, С-реактивный белок, гемоглобин, эндоскопическая картина Ghoshal et al [17] 2020 263 Альбумин, С-реактивный белок, гемоглобин, Grant et al [18] 2020 235 Альбумин, С-реактивный белок, гемоглобин Atia et al [19] 2021 153 Альбумин, С-реактивный белок Sahu et al [20] 2021 40 Альбумин, С-реактивный белок, гемоглобин, эндоскопическая картина Tanaka et al [21] 2021 95 Альбумин, С-реактивный белок, гемоглобин Syal et al [22] 2021 63 Альбумин, С-реактивный белок Jain S. et al [ (ОШ = 4,5; 95% ДИ: 3,2-6,5). Гетерогенность не выявлена: (I 2 ) = 0%, p = 0,6 (Рис.…”