INTRODUCTION: There are many instruments to measure disease activity in ulcerative colitis. While determining clinical activity according to these instruments many clinical and laboratory parameters are needing to be followed. Determination of disease activity with non-invasive and objective inflammatory indicators may be a practical and objective way. CRP / Albumin ratio (CAO) is an inflammatory marker that is considered to have prognostic value in various cancers, sepsis and acute pancreatitis. In this study we aim to investigate diagnostic performance CAR in determining clinical severity of ulcerative colitis.
METHODS: Between November 2011 and February 2017, hospital records and follow-up cards of patients with ulcerative colitis were reviewed retrospectively. 149 patients were included in the study. Patients demographic data, laboratory values, clinical disease activity according to Truelove & Witts criteria and endoscopic activity according to Mayo subscore and treatments were recorded. Diagnostic performance of CAR analysed to determining clinical severity.
RESULTS: Of the patients included in the study, 99 (62%) were male and 50 (38%) were female. Mean age was 45.22±14 years. When patients were grouped into remission, mild, moderate and severe disease according to disease activity, there were statistically significant difference between CRP, CAR, erythrocyte sedimentation rate (ESR) and albumin levels (p=0.001; p<0.05). Are under ROC (AUC) values for the diagnosis of severe disease were 0.941, 0.931, 0.888 and 0.883 for CAR, CRP, ESR and albumin levels, respectively. Cut-off value to determine severe disease for CAR was 0.6 (sensitivity: 88.9%, specificity of 90.3%, positive predictive value (PPV) 85.1%, negative predictive value (NPV) 92.8%, AUC: 0.941, p<0.001).
DISCUSSION AND CONCLUSION: There were significant relationship between CAR, CRP, ESR and albumin levels and clinical disease severity in patients with ulcerative colitis. CAR is a cheap and practical marker for the diagnosis of acute severe ulcerative colitis. (NCI-2018-0099.R1)