Impact of faecal calprotectin measurement on clinical decision-making in patients with Crohn’s disease and ulcerative colitis


Autoři: Anna Luisa Bathe aff001;  Eirini Mavropoulou aff001;  Nicolae-Catalin Mechie aff001;  Golo Petzold aff001;  Volker Ellenrieder aff001;  Steffen Kunsch aff001;  Ahmad Amanzada aff001
Působiště autorů: Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Goettingen, Goettingen, Lower Saxony, Germany aff001
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223893

Souhrn

Background

Faecal calprotectin (FC) seems to be the best available biomarker for the detection of intestinal inflammation in patients with inflammatory bowel disease (IBD). The aim of this study is to clarify whether the measurement of FC has changed the number of ultrasound and endoscopic procedures, drug modifications, as well as FC re-measurements in IBD patients.

Methods

This retrospective study included 242 IBD patients with available FC values (case cohort) and 46 patients without an available FC value (control cohort). Clinical consequences such as carrying out abdominal ultrasound, endoscopy, drug modification or FC re-measurement at the next ambulatory presentation or during in-patient stay were collected. Statistical analysis was performed to determine the association between clinical decision-making and patient’s characteristics, especially FC value.

Results

Overall, 192 (67%) clinical consequences were noted in both cohorts. In the case cohort 174 (91%) implications were noted compared to 18 (9%) in the control cohort (P < 0.001). In the case cohort, significantly more clinical consequences were detected in patients with Crohn’s disease (CD) as well as in ulcerative colitis (UC) patients with a FC value > 250 mg/Kg than in patients with a value of ≤ 250 mg/Kg. In CD patients with high FC values significantly increased numbers of abdominal ultrasounds, endoscopies and FC re-measurements were noted. In UC patients with high FC values significantly increased numbers of abdominal ultrasounds, drug modifications and FC re-measurements were noted.

Conclusion

Measurement of FC may alter physician’s clinical decision-making in IBD patients beside other clinical and diagnostic parameters. Further prospective and survey studies are warranted to evaluate the influence of FC measurement in the daily clinical decision-making.

Klíčová slova:

Decision making – Endoscopy – Inflammatory bowel disease – Multivariate analysis – Physicians – Platelets – Ulcerative colitis – Ultrasound imaging


Zdroje

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