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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.