Bedside Intestinal Ultrasound Performed in an Inflammatory Bowel Disease Urgent Assessment Clinic Improves Clinical Decision-Making and Resource Utilization
© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation..
Background: Patients with inflammatory bowel disease (IBD) require accessible, timely, and noninvasive strategies to monitor disease. The aim was to assess the integration of intestinal ultrasound (IUS) on decision-making and endoscopy utilization in a standardized care pathway.
Methods: This prospective, multicenter, international, observational cohort study included patients seen within a centralized model for IBD care was conducted during the COVID pandemic. Patients were evaluated with IUS alone or in combination with an in-clinic, unsedated sigmoidoscopy. Demographic, clinical, laboratory, and imaging data, clinical decisions, and need for urgent endoscopy, hospitalization, and surgeries were recorded.
Results: Of the 158 patients included, the majority had an established diagnosis of Crohn's disease (n = 123, 78%), and 47% (n = 75) of patients were on biologic therapy. IUS identified active inflammation in 65% (n = 102) of patients, and strictures in 14% (n = 22). Fecal calprotectin levels correlated with inflammation detected on IUS (median of 50 μg/g [Q1-Q3: 26-107 μg/g] without inflammation and 270 μg/g [Q1-Q3: 61-556 μg/g] with inflammation; p = 0.0271). In the majority of patients, clinical assessment with IUS led to an acute change in IBD-specific medications (57%, n = 90) and avoided or delayed the need for urgent endoscopy (85%, n = 134). Four patients were referred for urgent surgical consultation.
Conclusions: Point-of-care IUS used in a flare clinic pathway is a useful strategy to improve effective IBD care delivery and to assist in therapeutic management decisions, in many cases avoiding the acute need for endoscopy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
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| Enthalten in: |
Crohn's & colitis 360 - 5(2023), 4 vom: 04. Okt., Seite otad050 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
St-Pierre, Joëlle [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 30.10.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/crocol/otad050 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363022147 |
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| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. | ||
| 520 | |a Background: Patients with inflammatory bowel disease (IBD) require accessible, timely, and noninvasive strategies to monitor disease. The aim was to assess the integration of intestinal ultrasound (IUS) on decision-making and endoscopy utilization in a standardized care pathway | ||
| 520 | |a Methods: This prospective, multicenter, international, observational cohort study included patients seen within a centralized model for IBD care was conducted during the COVID pandemic. Patients were evaluated with IUS alone or in combination with an in-clinic, unsedated sigmoidoscopy. Demographic, clinical, laboratory, and imaging data, clinical decisions, and need for urgent endoscopy, hospitalization, and surgeries were recorded | ||
| 520 | |a Results: Of the 158 patients included, the majority had an established diagnosis of Crohn's disease (n = 123, 78%), and 47% (n = 75) of patients were on biologic therapy. IUS identified active inflammation in 65% (n = 102) of patients, and strictures in 14% (n = 22). Fecal calprotectin levels correlated with inflammation detected on IUS (median of 50 μg/g [Q1-Q3: 26-107 μg/g] without inflammation and 270 μg/g [Q1-Q3: 61-556 μg/g] with inflammation; p = 0.0271). In the majority of patients, clinical assessment with IUS led to an acute change in IBD-specific medications (57%, n = 90) and avoided or delayed the need for urgent endoscopy (85%, n = 134). Four patients were referred for urgent surgical consultation | ||
| 520 | |a Conclusions: Point-of-care IUS used in a flare clinic pathway is a useful strategy to improve effective IBD care delivery and to assist in therapeutic management decisions, in many cases avoiding the acute need for endoscopy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Crohn’s disease | |
| 650 | 4 | |a inflammatory bowel disease | |
| 650 | 4 | |a intestinal ultrasound | |
| 650 | 4 | |a point-of-care ultrasound | |
| 650 | 4 | |a ulcerative colitis | |
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| 700 | 1 | |a Goodsall, Thomas M |e verfasserin |4 aut | |
| 700 | 1 | |a Bryant, Robert V |e verfasserin |4 aut | |
| 700 | 1 | |a Christensen, Britt |e verfasserin |4 aut | |
| 700 | 1 | |a Vaughan, Rose |e verfasserin |4 aut | |
| 700 | 1 | |a Al-Ani, Aysha |e verfasserin |4 aut | |
| 700 | 1 | |a Ingram, Richard J M |e verfasserin |4 aut | |
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| 700 | 1 | |a Carter, Dan |e verfasserin |4 aut | |
| 700 | 1 | |a Lu, Cathy |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Novak, Kerri L |e verfasserin |4 aut | |
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