P1025 Prediction of Colectomy Risk After Severe Acute Inaugural Ulcerative Colitis Using the CRAB Score

Le résumé fourni par la source

Abstract Background Severe acute colitis (SAC) in ulcerative colitis (UC) remains a therapeutic emergency associated with a high risk of colectomy despite advances in biotherapies. The CRAB score, based on CRP and albumin, has been proposed as an early predictor of poor outcome. The aim of our study was to assess the prognostic value of the CRAB score for predicting colectomy within two years following a first episode of SAC. Methods We conducted a retrospective study over a 25-year period (2000–2025) including all patients admitted for inaugural SAC due to UC. Patients were followed for 24 months after initial hospitalization to determine colectomy risk. The CRAB score at admission was calculated using the formula: (CRP × 0.2) – (albumin × 0.26). Its prognostic performance was assessed using ROC curve analysis and comparison between groups (Mann–Whitney test). Results Forty-two patients were included, with a mean age of 35.1 ± 14 years and a female predominance (65%). At admission, median CRP was 101 mg/L [2–389], and median albumin was 28.8 g/L [10.2–36]. Eight patients (19%) underwent colectomy within two years. The CRAB score was significantly higher in these patients (p = 0.011). ROC analysis showed an AUC of 0.785. An optimal cutoff of 2.63 yielded 100% sensitivity and 65% specificity for predicting colectomy. The positive predictive value was 28%, while the negative predictive value reached 94.1%, indicating that the score is particularly effective for ruling out colectomy risk. Smoking was also significantly associated with colectomy occurrence (p < 0.001). Conclusion The CRAB score is a simple and relevant tool to identify, at an early stage, patients at risk of colectomy during a first episode of SAC in UC. Its integration in clinical practice may help stratify risk and guide early therapeutic escalation or surgical referral. Conflict of interest: Dr. Oueslati, Alaa: No conflict of interest Yacoub, Haythem: No conflict of interest Hajji, Rania: No conflict of interest Dhouha, Cherif: No conflict of interest Debbabi, Habiba: No conflict of interest Hassine, Hajer: No conflict of interest Kchir, Hela: No conflict of interest Maamouri, Nadia: No conflict of interest

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.