A newly proposed endoscopic score system to evaluate the entire small bowel and predict the prognosis in Crohn's disease.

Small bowel stenosis in patients with Crohn's disease leads to abdominal symptoms and can affect prognosis. The Simple Endoscopic Score for Crohn's Disease for the large bowel has been applied to the small bowel; however, stenosis scoring may be overestimated since it has a long diameter. This retrospective study aimed to devise a new endoscopic scoring system including the small bowel and evaluate whether it predicts the prognosis of Crohn's disease. The study included 103 patients with Crohn's disease at our hospital. We modified the Simple Endoscopic Score for Crohn's Disease and proposed a new scoring system; the modified applied Simple Endoscopic Score for Crohn's Disease was created by subtracting one point for stricture from the Simple Endoscopic Score for Crohn's Disease. Receiver operating characteristic curve analysis was performed to assess the accuracy of the modified applied score for Crohn's disease in predicting disease worsening within 1 year. Results were validated using the log-rank test. For the modified applied score, the area under the receiver operating characteristic curve for disease worsening within 1 year in 57 cases was 0.850. When the cutoff score was set to 9 points, the sensitivity and specificity were 72.7% and 80.6%, respectively. The log-rank test showed a significant difference ( = 0.027) in the risk of worsening within 1 year between the low (<9 points) and high (≥9 points) score groups. Thus, a higher modified applied Simple Endoscopic Score for Crohn's Disease may be associated with a significantly increased risk of disease worsening within 1 year.