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Ho Index for acute severe ulcerative colitis

Predicts failure of intravenous corticosteroids in acute severe ulcerative colitis.

Ho Index for acute severe ulcerative colitis
Mean stool frequency (day 3 of IV corticosteroids)
Colonic dilatation on abdominal imaging (transverse diameter >=5.5 cm)
Hypoalbuminaemia (albumin <=30 g/L / 3.0 g/dL) on day 3
Result0 points

Low risk of corticosteroid failure (approximate medical therapy failure rate ~11 %).

Estimated corticosteroid failure rate
~11 %

When to use

  • Predicting on day 3 of IV corticosteroids whether a patient with acute severe ulcerative colitis is likely to fail medical therapy and need second-line treatment or colectomy.

Formula

Stool frequency (0/1/2/4 points) + colonic dilatation >=5.5 cm (4 points) + hypoalbuminaemia <=30 g/L (1 point). Range 0-9.

Pearls and pitfalls

  • Score 0-1 low risk, 2-3 moderate risk, >=4 high risk of failing IV corticosteroids.

References

  1. Ho GT, et al. Aliment Pharmacol Ther. 2004;19(10):1079-87.