S119 Diagnostic Transition from Ulcerative Colitis to Crohn’s Disease: A Single-Center Retrospective Study
Notice bibliographique
Résumé
Background: Differentiating between ulcerative colitis (UC) and Crohn’s disease (CD) can be clinically challenging. Established diagnostic criteria for inflammatory bowel disease (IBD) are based on clinical, endoscopic, radiographic, and histological findings. However, some patients initially diagnosed with UC may later present characteristics typical of CD, necessitating a diagnostic revision. Population studies from Scandinavia have reported diagnostic transition rates from UC to CD ranging from 3% to 14% over a 5-year follow-up period. Despite the overlap in the management of UC and CD, an accurate diagnosis is essential for optimizing treatment strategies, surgical interventions, and eligibility for clinical trials. The aim of this study is to determine the frequency of diagnostic migration from UC to CD and to describe the clinical and demographic characteristics of patients who experienced this transition. Methods: This retrospective study was conducted at the IBD of the General Hospital of Mexico “Dr. Eduardo Liceaga.” Medical records of 164 patients diagnosed with UC were reviewed. Patients who experienced a diagnostic transition to CD, confirmed through clinical, endoscopic, radiological, and histological findings consistent with CD, between April 2023 and April 2024, were identified. Data collected included demographic and clinical information such as age, gender, Montreal classification, treatments received, and surgical history. Statistical analysis was performed using SPSS software version 19, applying descriptive statistics to calculate frequencies and means with standard deviation for the clinical and demographic characteristics. Results: Of the 164 UC patients, 5 (3.05%) experienced a diagnostic transition to CD during the follow-up period. The mean duration from UC diagnosis to diagnostic transition was 2.2±1.6 years. The gender distribution was 3 males (60%) and 2 females (40%). The mean age at initial UC diagnosis was 42.46 ± 14.13 years, and at the time of re-evaluation and transition to CD was 44.4 ± 14.13 years. Prior to the transition, all patients had UC classified as E3 according to the Montreal classification. Three patients (60%) had not undergone prior surgery, while 1 had a 2-stage total proctocolectomy with ileal pouch-anal anastomosis and another had a total colectomy with ileostomy. The mean number of hospitalizations before the diagnostic transition was 1.5 ± 0.5. Prior to the transition, 3 patients were on biological therapy, and 2 were on conventional therapy. Following the diagnosis of CD, most patients were classified as A2 (80%), L3 (60%), and B2 (60%) according to the Montreal classification. One patient (20%) required ileal resection with ileostomy. Conclusions: In this study, 3.05% of patients initially diagnosed with UC were reclassified to CD within an average of 2.2±1.6 years. These findings underscore the importance of thorough follow-up with periodic re-evaluations to enhance management and outcomes for IBD patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».