Longitudinal Laboratory Data Predicts Complication in Crohn’s Disease Patients
By LabMedica International staff writers Posted on 27 Sep 2022 |
Stenosis, fistulization, and perforation of the bowel are severe outcomes which can occur in patients with Crohn’s disease. Accurate prediction of these events may enable clinicians to alter treatment strategies and avoid these outcomes.
Crohn’s disease is a chronic inflammatory condition of the human gastrointestinal tract of undetermined etiology. It is characterized by a relapsing and remitting course and by significant morbidity from chronic abdominal pain, diarrhea, and perianal abscesses.
Gastroenterologists at the Royal Brisbane and Women’s Hospital (Brisbane, Australia) and their colleagues studied the correlation between longitudinal laboratory testing and subsequent intestinal complications in 246 patients with Crohn’s disease. This was an observational cohort of patients with Crohn’s disease at a single center were analyzed between 01/01/1994 and 06/30/2016. A complication was defined as the development of an intestinal fistula, stenosis, or perforation.
The team analyzed C-reactive protein (CRP, (mg/L), erythrocyte sedimentation rate (ESR, mm/h), hemoglobin level (g/L), mean cell volume (MCV, fL), white blood cell count (WCC, × 109/L), platelet count (× 109/L), neutrophil count (× 109/L), fecal calprotectin (mcg/g feces), ferritin (mcg/L), alanine transferase (ALT, IU/L), and albumin (g/L).
The scientists reported that n 246 patients they observed over a median of 5.72 years, 134 complications occurred. Minimum or maximum value in a preceding window period of one year was most strongly associated with subsequent complication. A Longitudinal Laboratory score of ≥ 2 (maximum albumin level < 39 g/L = 1, maximum mean cell volume < 88 fL = 1, minimum platelet count > 355 × 109/L = 1, minimum C reactive protein > 5 mg/L = 1) was 62% sensitive and 91% specific in identifying patients who develop a subsequent complication. A Longitudinal Laboratory score ≥ 2 predicted the development of a future complication, with a positive predictive value of 84%, and a negative predictive value of 76%.
The authors concluded that consistently reduced serum albumin and MCV, and consistently increased CRP and platelet count are associated with future development of complications in patients with Crohn’s disease. These laboratory changes are observed up to two years prior to the development of a complication. In addition to recognized markers of poor outcome in Crohn’s disease, longitudinal laboratory tests may be assessed and used to provide a rationale for timely escalation of therapy. The study was published on September 20 2022 in the journal Digestive Diseases and Sciences.
Related Links:
Royal Brisbane and Women’s Hospital
Latest Hematology News
- Next Generation Instrument Screens for Hemoglobin Disorders in Newborns
- First 4-in-1 Nucleic Acid Test for Arbovirus Screening to Reduce Risk of Transfusion-Transmitted Infections
- POC Finger-Prick Blood Test Determines Risk of Neutropenic Sepsis in Patients Undergoing Chemotherapy
- First Affordable and Rapid Test for Beta Thalassemia Demonstrates 99% Diagnostic Accuracy
- Handheld White Blood Cell Tracker to Enable Rapid Testing For Infections
- Smart Palm-size Optofluidic Hematology Analyzer Enables POCT of Patients’ Blood Cells
- Automated Hematology Platform Offers High Throughput Analytical Performance
- New Tool Analyzes Blood Platelets Faster, Easily and Accurately
- First Rapid-Result Hematology Analyzer Reports Measures of Infection and Severity at POC
- Bleeding Risk Diagnostic Test to Reduce Preventable Complications in Hospitals
- True POC Hematology Analyzer with Direct Capillary Sampling Enhances Ease-of-Use and Testing Throughput
- Point of Care CBC Analyzer with Direct Capillary Sampling Enhances Ease-of-Use and Testing Throughput
- Blood Test Could Predict Outcomes in Emergency Department and Hospital Admissions
- Novel Technology Diagnoses Immunothrombosis Using Breath Gas Analysis
- Advanced Hematology System Allows Labs to Process Up To 119 Complete Blood Count Results per Hour
- Unique AI-Based Approach Automates Clinical Analysis of Blood Data