Management of acute severe ulcerative colitis

Table 1 Modified Truelove and Witt’s criteria for classification of severity of ulcerative colitis

	Mild	Moderate	Severe
Bloody stools per day	< 4	4-6	> 6
Pulse	< 90 bpm	≤ 90 bpm	> 90 bpm
Temperature	< 37.5 °C	≤ 37.8 ºC	> 37.8 °C
Hemoglobin	> 11.5 gm/dL	≥ 10.5 gm/dL	< 10.5 gm/dL
ESR	< 20 mm/h	≤ 30 mm/h	> 30 mm/h
CRP	Normal	≤ 30 mg/dL	> 30 mg/dL

Table 2 Ten year follow up of patients of Oxford cohort categorized at day 7 of intensive therapy

Parameter	Complete responders	Incomplete responders
Colectomy rate at 1 yr	5%	54%
Number requiring colectomy	6/19 (32%)	10/13 (76.9%)
Maximum steroid free remission	3.5 yr	< 1 yr

Table 3 Long term response rates to cyclosporin[38]

Initial response	74%
1 yr	65% relapsed
3 yr	90% relapsed
7 yr	58% colectomy rates

Table 4 Mortality according to day of surgery after intensive steroid therapy

Timing of surgeryTotal emergency surgeries = 72	Number of patients	Mortality
Overall	51	8
≤ 5 d	17	0/17
> 5 d	34	8/34