The Dublin Score: a new approach for assessment of Ulcerative Colitis

Aims Endoscopy plays a fundamental role in management and follow up of patients with Ulcerative Colitis. MES score (Mayo endoscopic score) and UCEIS (Ulcerative Colitis index of severity) are commonly studied by physicians to assess the disease severity and its activity. But both scoring systems focus only on the mucosal lesions, none of them include the extent. The degree of ulcerative colitis burden of luminal inflammation (DUBLIN) score is calculated as a product of MES (0-3) and disease extent (E1-E3), Thus, the aims of this study are to assess whether new scoring systems were useful to detect serious disease and also to study the significant factors associated with medical treatment failure among patients with UC.

Methods A retrospective study was conducted at the Gastroenterology Department of the Universitaire hospital center Sahloul, Sousse, involving 50 patients with UC who were presented with an acute flare-up and had undergone a colonoscopy. Endoscopic scores, clinical and biological data were collected.

Results 50 patients with an average age of 41 years and a male/female ratio of 0.85 were included in the study. Among the patients, 24 (48%) were receiving aminosalicylates, 11 (22%) were on immunosuppressants, and 4 were receiving TNF-inhibitors. The average C-reactive protein (CRP) level was 72.7+/- 66.7, and the blood albumin levels ranged from 17 to 42.3 g/L. Most patients had a moderate to severe flare-up, with an average MES score of 2.5. The distribution of disease extent was as follows: E1 (n=2, 4%), E2 (n=16, 32%), and E3 (n=32, 64%). A significant correlation was proved between the DUBLIN score, MES score, and UCEIS score. The DUBLIN score exhibited a statistically significant correlation with both the MES score (r=0.733, p<0.001) and the UCEIS score (r=0.652, p<0.001). Furthermore, the UCEIS score showed a significant correlation with the MES score (r=0.816, p<0.001). However, no statistically significant correlation was found between the scores and the biological parameters (CRP, albumin). Multivariate analysis revealed that the DUBLIN score (DS) was significantly associated with therapeutic failure (p=0.008), with an odds ratio of 1.965. However, neither the UCEIS score (p=0.494) nor the C-Reactive protein (p=0.320) showed a significant association with therapeutic failure.

Conclusions Our study demonstrated a significant correlation between the DUBLIN score, UCEIS score, and MAYO score, emphasizing the significance of the DUBLIN score as a predictor of therapeutic failure.

Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025