Assessment of the Severity of Endoscopic Lesions in Ulcerative Colitis: Endoscopist’s Evaluation Versus Ulcerative Colitis Endoscopic Index Score

Aims The aim of this study was to explore the interobserver variation in the assessment of endoscopic lesions in Ulcerative colitis (UC) and to compare it with the UC endoscopic index of severity (UCEIS).

Methods This is a retrospective study performed in University hospital center of Sahloul in Sousse between January 2017 and December 2018. All patients with UC who had a colonoscopy were included. The UCEIS was calculated and compared to endoscopist’s assessment .The range in the UCEIS scores is 0 to 8 which was stratified into four grades: remission (0–1); mild (2–4); moderate (5–6); and severe (7–8).

Results A total of eighty-three low digestive endoscopies were performed to 63 patients during the follow-up. The average age of included patients was 42,5 years [15-75 years] with sex ratio of 0,89. The UC was categorized as pancolitis in two third of cases. The indication of colonoscopy was: a new flare of UC in 63,9 %, a control before the restoration of intestinal continuity in 18,1 %, endoscopic screening in 9,6 % and endoscopic control after an acute severe flare of UC in 8,4 % of cases. Among 63 colonocopy findings with UCEIS ≥ 6, 65 % were categorized by endoscopists as moderate attack and 22,2 % as severe attack of UC. Furthermore, with UCEIS = 8, endoscopists judged endoscopic lesions as moderate in almost the half and as severe lesions in 25 % of colonoscopic explorations. For a UCEIS ≤ 3, 76,9 % of endoscopic lesions were described as mild.

Conclusions Our study showed that endoscopist’s assessment of endoscopic lesions was not usually accurate. UCEIS score is a useful instrument for evaluating the severity of endoscopic lesions in UC and for avoiding interobserver variation.

Citation: Hammami A, Hassine A, Zinelabidine F etal. eP259 ASSESSMENT OF THE SEVERITY OF ENDOSCOPIC LESIONS IN ULCERATIVE COLITIS: ENDOSCOPIST’S EVALUATION VERSUS ULCERATIVE COLITIS ENDOSCOPIC INDEX SCORE. Endoscopy 2021; 53: S182.

Publication History

Article published online:
19 March 2021