[Predictive factors of recurrence after surgery in severe attacks of hemorrhagic ulcerative proctocolitis].
OBJECTIVE
The purpose of our study was to determine clinical, biological or endoscopic factors that predict surgery after a glucocortico steroid treatment failure in severe attacks of ulcerative colitis.


METHODS
Sixty one patients were analyzed. A therapeutic response for glucocorticosteroid was defined as the absence of resort to surgery within the first 30 days after hospitalization. Predictive factors were assessed using univariate and multivariate analysis.


RESULTS
Fifteen patients (24.6%) had a medical response. In univariate analysis, predictive factors of surgery were: male sex, tobacco, number of colitis attacks in case history, temperature over 38 degrees C, erythrocyte sedimentation rate over 30 mm, systolic blood pressure below 11, deep and wide ulcers. During the course, bowel movements/day over 7, pulse over 90/mn, temperature over 38 degrees C on day 3 after treatment initiation as well as passage of blood on day 5 were identified as predictors of surgery. In multivariate analysis, bowel movements over 7/day on day 3 of hospitalization was independently predicted a surgery.


CONCLUSIONS
Bowel movements/day over 7 on day 3 of hospitalization was the only independently predictive factor of surgery after glucortico steroid treatment failure
Service de Gastro-entdrologie, Hôpital universitaire Sahloul, Sousse, Tunisie.
Hela
H
Elloumi
Ahmed
A
Ben Abdelaziz
Dalenda
D
Arfaoui
Youssef
Y
Lassoued
Rached
R
Letaief
Ali
A
Jmaa
Hassen
H
Ghannem
Salem
S
Ajmi
D000328:Adult; D001799:Blood Sedimentation; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000601:surgery*; D003113:Colonoscopy; D003672:Defecation / Q000502:physiology; D005260:Female; D005334:Fever / Q000503:physiopathology; D005544:Forecasting; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000150:complications; D008297:Male; D011350:Proctocolitis / Q000188:drug therapy / Q000601:surgery*; D012008:Recurrence; D012737:Sex Factors; D012907:Smoking; D017211:Treatment Failure
D005938:Glucocorticoids