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Travis criteria for acute severe ulcerative colitis

Day-3 prediction of colectomy in acute severe ulcerative colitis.

Travis criteria for acute severe ulcerative colitis
Stool frequency on day 3 of IV corticosteroids
stools/day
C-reactive protein (CRP) on day 3
mg/L
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When to use

  • Predicting the need for colectomy on day 3 of intravenous corticosteroids in acute severe ulcerative colitis, to guide early escalation to rescue medical therapy or surgery.

Formula

High risk of colectomy if, on day 3 of IV corticosteroids: stool frequency >8/day, OR stool frequency 3–8/day together with CRP >45 mg/L.

Pearls and pitfalls

  • Derived from a prospective cohort of 49 patients with acute severe ulcerative colitis admitted to the Oxford unit in 1996.
  • Contemporary colectomy rates in patients meeting the criteria are lower than the original 85% because of improved rescue therapies (e.g. infliximab, ciclosporin), but the criteria still identify patients failing corticosteroids.

References

  1. Travis SP, Farrant JM, Ricketts C, et al. Predicting outcome in severe ulcerative colitis. Gut. 1996;38(6):905-910.