P0908 Prognostic Nomogram Incorporating Limberg Score for Predicting Bowel Surgery in Patients with Ulcerative Colitis

Abstract Background This study aimed to assess the role of intestinal ultrasound (IUS) in monitoring and predicting long-term bowel surgery in patients with ulcerative colitis (UC). Methods This retrospective study analyzed documented IUS examinations of UC patients from a prospective inflammatory bowel disease registry. A nomogram was constructed to predict bowel surgery based on factors identified by both multivariate Cox and logistic regression model. Model performance was assessed using receiver-operating characteristic (ROC) curves and decision curve analysis (DCA). Results A total of 171 patients were enrolled. Significant correlations were observed between IUS parameters and disease activity as assessed by colonoscopy, as well as with other inflammatory indices. During a median follow-up of 32 months, 12 patients (7.02%) underwent UC-related bowel surgery. Factors associated with bowel surgery identified by the Cox regression included the Limberg score (OR 3.86, 95% CI 0.98−15.26, p=0.054), steroids use (OR 7.31, 95% CI 0.85−62.51, p=0.069), perianal lesions (OR 37.19, 95% CI 1.94−712.34, p=0.016), and age at diagnosis (OR 1.08, 95%CI 1.02−1.13, p=0.007). A nomogram incorporating these factors was established. Both ROC curve and DCA analysis indicated that the nomogram, which included the Limberg score, had an area under the curve (AUC) of 0.872 and a C-Index of 0.875. The nomogram based on logistic regression analysis also showed good performance. Conclusion We developed and validated a prognostic nomogram incorporating the Limberg score to identify patients with UC most likely to require bowel surgery. This nomogram can improve risk stratification and aid personalized therapeutic decisions for UC patients.