title: Developing a novel risk-scoring system for predicting relapse in patients with ulcerative colitis: A prospective cohort study.
abstract: OBJECTIVE
  Ulcerative Colitis (UC) follows a natural clinical course of relapses and remissions. The aim of this study was to construct a risk-scoring formula in order to enable predicting relapses in patients with UC.
  
  
  METHODS
  From October 2012 to October 2013, 157 patients from Shiraz, southern Iran who were diagnosed with UC and in remission were enrolled. At 3-month intervals, multiple risk factors of hemoglobin, complete blood counts, serum iron and albumin, erythrocyte sedimentation rate, and faecal calprotectin levels, sex, age, cigarette smoking, positive family history of inflammatory bowel diseases, past history of appendectomy, extra-intestinal accompanying diseases, extent of disease at the beginning of study, number of previous relapses, duration of disease and duration of remission before the study were assessed. Univariate and multivariate logistic regression were applied to fit the final model. The new risk-scoring system accuracy was assessed using receiver-operating-characteristics (ROC) curve analysis.
  
  
  RESULTS
  Seventy four patients (48.1%) experienced a relapse. Multivariate analysis revealed that relapses could significantly be predicted by the level of fecal calprotectin (OR=8.1), age (OR=9.2), the Seo activity index (OR=52.7), and the number of previous relapses (OR=4.2). The risk scoring formula was developed using the regression coefficient values of the aforementioned variables.
  
  
  CONCLUSIONS
  Four predictor variables were significant in the final model and were used in our risk-scoring formula. It is recommended that patients who achieve high scores are diligently observed, treated, and followed up.
authors: Seyed Vahid Hosseini, Colorectal Research Center, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Seyed Vahid
authors: SV
authors: Hosseini
authors: Ali Reza Safarpour, Gastroenterohepatology Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Ali Reza
authors: AR
authors: Safarpour
authors: Seyed Alireza Taghavi, Gastroenterohepatology Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Seyed Alireza
authors: SA
authors: Taghavi
keywords: Cohort Study; Prediction; Relapse; Ulcerative Colitis