Correlation between Mayo Clinic Score and Endoscopic Scores in Ulcerative Colitis

Aims Assessing the severity of ulcerative colitis (UC) is essential for determining appropriate therapeutic management and monitoring disease progression. The clinical or endoscopic Mayo score is commonly used to evaluate this progression. The aim of this study is to analyze the correlation between clinical and endoscopic Mayo scores in patients with UC.

Methods This was a retrospective, descriptive, and analytical monocentric study conducted in the gastroenterology department over a 34-year period (1990–2024), involving patients with ulcerative colitis (UC) under follow-up. Clinical data were collected exclusively from medical records. Both clinical and endoscopic Mayo scores were used to assess the severity of UC, with severity levels classified from 0 to 3. Two groups were compared: those with endoscopically active disease versus those with inactive disease. The association between the clinical and endoscopic Mayo sub-scores was analyzed using logistic regression.

Results Among a total of 595 patients followed for ulcerative colitis (UC), the mean age was 36.4±12.4 years. The female-to-male ratio was 1.22, with a predominance of females. Clinically, the median duration from diagnosis was 6 years [6; 12], with a median follow-up duration of 3 years [2; 5], ranging from a minimum of 1 month to a maximum of 20 years. Of the patients, 37% had left-sided disease, followed by 32.1% with distal disease, and 30.9% with pancolitis. Regarding the initial clinical Mayo scores, 47% of patients had a score greater than 10, followed by 26.6% with scores between 6 and 10, 20% with scores between 3 and 5, and 1.2% with scores less than or equal to 2. 40% of patients had an initial endoscopic Mayo score of 3, followed by 29.6% with a score of 2, 28.5% with a score of 1, and 1.9% with a score of 0. When comparing the groups with or without signs of endoscopic activity (Mayo score≤1), a statistically significant difference was found, with 98.8% of patients in endoscopic remission having a clinical Mayo score indicating disease inactivity (p<0.001). In univariate analysis, a clinical Mayo score of 2 or less was associated with endoscopic remission (endoscopic Mayo score<1), with an odds ratio (OR) of 8.4, 95% confidence interval [1.1–62.12], p<0.001.

Conclusions The study shows a significant correlation between the clinical and endoscopic Mayo scores in patients with UC, indicating that clinical symptoms may partially reflect the severity of endoscopic lesions. However, endoscopy is essential for an accurate assessment of intestinal inflammation, guiding therapeutic decisions. The Mayo scores are confirmed as useful for evaluating prognosis and adjusting treatment, highlighting their combined value with endoscopy for optimal patient monitoring.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025