Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2023; 29(48): 6208-6221
Published online Dec 28, 2023. doi: 10.3748/wjg.v29.i48.6208
Clinical value of the Toronto inflammatory bowel disease global endoscopic reporting score in ulcerative colitis
Xin-Yue Liu, Zi-Bin Tian, Li-Jun Zhang, Ai-Ling Liu, Xiao-Fei Zhang, Jun Wu, Xue-Li Ding
Xin-Yue Liu, Zi-Bin Tian, Ai-Ling Liu, Jun Wu, Xue-Li Ding, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Li-Jun Zhang, Department of Population and Quantitative Health Sciences (PQHS), School of Medicine, Case Western Reserve University, Cleveland, OH 44106, United States
Xiao-Fei Zhang, Department of Gastroenterology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao 266011, Shandong Province, China
Author contributions: Ding XL, Liu XY, and Tian ZB designed this study; Zhang LJ evaluated and reviewed the statistical methods; Ding XL, Liu XY, Liu AL, Zhang XF, and Wu J collected data; Liu XY analysed the data; Liu XY edited the manuscript; Ding XL, Liu AL, Tian ZB revised the manuscript; and all authors have read and approved the final manuscript.
Supported by Clinical Medicine + X Research Project of the Affiliated Hospital of Qingdao University in 2021, No. QDFY+X202101036; Qingdao Medical and Health Research Program in 2021, No. 2021-WJZD166; and Youth Project of Natural Science Foundation of Shandong Province, No. ZR2020QH031.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Qingdao University (Approval No. QYFY WZLL 28085).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no potential conflicts of interest related to this study.
Data sharing statement: The data used in this study can be obtained from the corresponding author upon reasonable request.
STROBE statement: The authors have read the STROBE statement, and the manuscript was revised in accordance with the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Li Ding, PhD, Associate Professor, Department of Gastro-enterology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China. dingxueli@qdu.edu.cn
Received: October 10, 2023
Peer-review started: October 10, 2023
First decision: November 6, 2023
Revised: November 25, 2023
Accepted: December 12, 2023
Article in press: December 12, 2023
Published online: December 28, 2023
Processing time: 77 Days and 14.9 Hours
ARTICLE HIGHLIGHTS
Research background

Endoscopy is crucial in the diagnosis, assessment, and management of ulcerative colitis (UC). Several endoscopic scoring systems have been established to make endoscopic evaluation quantified and objective, including the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score and Mayo Endoscopic Subscore (MES). The Toronto Inflammatory Bowel Disease Global Endoscopic Reporting (TIGER) score for UC, which considers the extent of UC involvement and reflects the number of segments with moderate-to-severe inflammation, was proposed in 2022.

Research motivation

Although the TIGER score is a novel and reliable tool for reflecting complete endoscopic inflammation, its clinical value remains unclear.

Research objectives

To assess the clinical value of the TIGER score by comparing it with the UCEIS score and MES.

Research methods

We performed a retrospective study that included 166 patients with UC who underwent total colonoscopy. Spearman's rank correlation coefficient was used to estimate the linear associations of three scores and laboratory/clinical parameters. The receiver-operating characteristic curve was performed to compare the predictive potentials of the three scores for predicting severe UC, patients’ recent advanced treatment, and 1-year readmission. Univariate and multivariable logistic regression analyses were performed to investigate the independent risk factors for treatment escalation.

Research results

The TIGER score showed a significant correlation with the UCEIS score, MES, and laboratory indices, particularly C-reactive protein levels. Additionally, the TIGER score exhibited the best predictive capability for diagnosing patients with severe UC, upgrading treatment options, and 1-year readmission and a TIGER score of ≥ 317 was found to be an independent risk factor for treatment escalation in UC.

Research conclusions

The TIGER score exhibits an advantage in assessing the disease severity of UC, guiding treatment decisions, and predicting short-term prognosis compared to the UCEIS score and MES.

Research perspectives

The TIGER score may have significant clinical utility in evaluating, treating, and managing patients with UC, although multicenter prospective studies are required to promote its use.