Predictive factors of glucocorticosteroid treatment failure in severe acute idio- pathic colitis

Introduction : The purpose of our study was to determine clini- cal, biological or endoscopic factors that could predict glucocorti- costeroid treatment failure in acute colitis. Patients and Methods : Fifty-four Tunisian Caucasian patients with acute idiopathic colitis (ulcerative colitis in 53 patients, Crohn's colitis in 1 patient) have been evaluated. Non-therapeutic response was defined as over 6 bowel movements per day, blood vis- ible to the naked eye in stools on the fifth day after admission or the development of a complication inducing a resort to surgery. Predic- tive factors were assessed using bivariate and multivariate analysis. Results : Thirty-nine patients (72.2%) had no medical response. In univariate analysis, predictive factors of therapeutic failure were : male sex, tobaccO. previous history of colitis attacks, bowel movements per day over seven at admission and on day three, and pulse rate over 90/mn, temperature over 38°C, systolic blood pres- sure below 11 on day 3 and on day 5 after admission. In multi- variate analysis, bowel movements over seven per day on day 3 of hospitalization and male sex independently predicted a failure of glucorticosteroid treatment. Conclusion : Bowel movements per day over seven on day 3 of hospitalization and male sex were the independently predictive factors of failure of glucocorticosteroid treatment. (Acta gastro- enterol. belg., 2005, 68, 226-229).