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Restorative proctocolectomy for inflammatory bowel disease

The Padova prognostic score for colitis in predicting long-term outcome and quality of life

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

In 10–20% of cases, it is impossible to distinguish between ulcerative colitis and Crohn’s colitis, affecting the possibility to predict the long-term outcome after restorative proctocolectomy (RPC). The study aimed to assess the accuracy of a new prognostic score for inflammatory bowel diseases (IBD) colitis [the Padova Prognostic Score for Colitis (PPSC)] in predicting long-term clinical/functional outcome and quality of life after RPC.

Materials and methods

The PPSC was created by the integration of histological and clinical information. The accuracy of the PPSC was tested in predicting long-term clinical outcome (i.e. pouch complications/survival) and quality of life of 58 consecutive patients who had undergone RPC in our institute from 1984 to 2004. Clinical outcome was assessed with an ad hoc functional questionnaire and the revision of the hospital and outpatients clinic notes. Quality of life surveys were carried out with the Padova IBD Quality of Life (PIBDQL) and with Cleveland Global Quality of Life (CGQL) scores.

Results

The PPSC predicted pouch fistulae (accuracy = 84.5%; sensitivity = 50%; specificity = 90%) and changes in sexual life (accuracy = 71%; sensitivity = 23%; specificity = 87%). The PPSC also predicted the PIBDQL score with an accuracy of 62%, a sensitivity of 28% and a specificity of 97%, whilst it predicted the CGQL score with an accuracy of 29%, a sensitivity of 12% and a specificity of 80%. The PPSC failed to predict pouchitis or pouch failure.

Conclusions

The Padova Prognostic Score for Colitis proved effective in predicting pouch fistulae or abscesses, but not pouchitis and pouch failure. The PPSC was accurate in predicting disease-specific quality of life.

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Authors contributions

Marco Scarpa: conception and design, drafting the manuscript, statistical expertise; Claudia Mescoli: acquisition of data, drafting the manuscript, technical support; Massimo Rugge: conception and design, drafting the manuscript, supervision; Renata D’Incà: acquisition of data, critical revision of the manuscript, technical support; Cesare Ruffolo: acquisition of data, critical revision of the manuscript, technical support; Lino Polese: acquisition of data, critical revision of the manuscript, technical support; Davide F. D’Amico: analysis and interpretation of data, critical revision of the manuscript, supervision; Giacomo C. Sturniolo: analysis and interpretation of data, critical revision of the manuscript, obtaining funding; Imerio Angriman: conception and design, drafting the manuscript, supervision.

Financial disclosure

None of the authors have any relevant financial interest in the manuscript.

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Authors and Affiliations

  1. Department of Surgery, Veneto Oncological Institute (IOV-IRCCS), Padua, Italy

    Marco Scarpa

  2. Department of Medical Diagnostic Sciences & Special Therapies (Pathology Section), University of Padova, Via Aristide Gabelli, 61, 35128, Padua, Italy

    Claudia Mescoli & Massimo Rugge

  3. Department of Pathology, Veneto Oncological Institute (IOV-IRCCS), Padua, Italy

    Massimo Rugge

  4. Department of Surgical & Gastroenterological Sciences (Gastroenterology Section), University of Padova, Padua, Italy

    Renata D’Incà & Giacomo C. Sturniolo

  5. Department of Surgical & Gastroenterological Sciences (Clinica Chirurgica I Section), University of Padova, Padua, Italy

    Cesare Ruffolo, Lino Polese, Davide F. D’Amico & Imerio Angriman

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  1. Marco Scarpa
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  2. Claudia Mescoli
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  7. Davide F. D’Amico
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  8. Giacomo C. Sturniolo
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Corresponding author

Correspondence to Massimo Rugge.

Additional information

In memory of Professor Andrea Tropea.

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Scarpa, M., Mescoli, C., Rugge, M. et al. Restorative proctocolectomy for inflammatory bowel disease. Int J Colorectal Dis 24, 1049–1057 (2009). https://doi.org/10.1007/s00384-009-0700-8

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  • DOI: https://doi.org/10.1007/s00384-009-0700-8

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