Open AccessLow serum albumin at admission is a predictor of early colectomy in patients with moderate to severe ulcerative colitis
Author(s) -
Tanaka Makoto,
Takagi Tomohisa,
Naito Yuji,
Uchiyama Kazuhiko,
Hotta Yuma,
Toyokawa Yuki,
Kashiwagi Saori,
Kamada Kazuhiro,
Ishikawa Takeshi,
Yasuda Hiroaki,
Konishi Hideyuki,
Itoh Yoshito
Publication year - 2021
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12506
Subject(s) - medicine , colectomy , ulcerative colitis , gastroenterology , logistic regression , odds ratio , confidence interval , serum albumin , albumin , receiver operating characteristic , disease
Background and Aim Several studies have identified postinduction therapy predictors of long‐term outcomes of ulcerative colitis (UC) in patients who experienced the first attack of the disease or relapsed after therapy. We aimed to identify the preinduction therapy predictors at admission that predicted early colectomy in patients with moderate to severe UC. Methods Ninety‐five patients with moderate to severe UC who underwent induction therapy at the Kyoto Prefectural University of Medicine hospital between August 2008 and March 2020 were retrospectively included and categorized into two groups: the colectomy group ( n = 27) and the noncolectomy group ( n = 68). The clinical parameters (age, gender, disease extent, and disease activity on admission), induction therapies administered [including 5‐aminosalicylic acid, steroids, immunomodulators, calcineurin inhibitor, and anti‐Tumor Necrosis Factor (TNF)‐α antibodies], and laboratory data (hemoglobin, albumin, C‐reactive protein, and cytomegalovirus reactivation on admission) were evaluated and compared between the two groups. Multivariate logistic regression analyses were performed to identify significant predictors of early colectomy, and P < 0.05 was considered significant. Results All clinical parameters were not significant predictors of colectomy. Among laboratory parameters, the serum albumin level on admission was a significant independent predictor of colectomy (odds ratio: 6.097, 95% confidence interval: 1.8310–20.3047). Receiver operating characteristic curves were plotted for the serum albumin levels of the 95 patients at admission. The cut‐off value of serum albumin was 2.45 g/dL. Conclusions When the serum albumin level of UC patients at admission is below 2.45 g/dL, we should consider presenting the option of surgical treatment to patients.