INFORMATION AND REFERENCES
CDEIS (Crohn's Disease Endoscopic Index of Severity) is an index for determining the severity of Crohn's disease with endoscopic localization to ileum and colon. It was developed by the study group GETAID (Groupe d'Étude des Affections Thérapeutique Inflammatoires du tube Digestif) with the aim to investigate the correlation between the results of clinical, biological and endoscopic findings and to evaluate treatment effectiveness. The variables are linked and evaluated on the basis of endoscopic findings (1).
CDEIS score considers 4 parameters, each one evaluated in 5 pre-defined segments of the colon (ileum, ascending colon, transverse colon, descending colon and sigmoid loop, and rectum). The score can be calculated even in case of incomplete investigations, as the results of the individual segments are divided by the number of segments investigated.
The presence of stenosis, as a result of ulcer or not, increases the score at the end of the computation.
| Ileum | Right
colon | Transverse
colon | Left colon
and sigma | Rectum | Total |
Deep ulcerations
(12 if present, 0 if absent) | ___+ | ___+ | ___+ | ___+ | ___+ | Total 1 |
Superficial ulcerations
(6 if present, 0 if absent) | ___+ | ___+ | ___+ | ___+ | ___+ | Total 2 |
Surface involved
by disease (cm VAS*) | ___+ | ___+ | ___+ | ___+ | ___+ | Total 3 |
Surface involved
by ulcerations (cm VAS*) | ___+ | ___+ | ___+ | ___+ | ___+ | Total 4 |
| Sum of Totals 1+2+3+4 = | Total A |
| Number of segments visualized in part or entirely (from 1 to 5) | n |
| Total A/n = | Total B |
| if ulcerated stenosis in any segment, add 3 | Total C |
| If non-ulcerated stenosis in any segment, add 3 | Total D |
| Total B + C + D = | CDEIS score |
* VAS: Visuo Analogue Scale.
CAUTION: If the VAS scale is in mm, values are to be expressed in inches (mm/10); similarly if the VAS scale is in percentage, the score to be reported is percentage value divided by 10.
Example: selected value 21mm = 21%, correspondent score is 2.1 (21/10).
Decoding table (2)
| Score | Decoding |
| < 3 | remission |
| 3 - 8 | mild endoscopic activity |
| 9 - 12 | moderate endoscopic activity |
| > 12 | severe endoscopic activity |
A decrease of 50% of the CDEIS score has recently been proposed as prognostically significant.
Below are some examples endoscopic images.
| Deep ulcerations |   | | Superficial ulcerations |   |
| Ulcerated stenosis |   | | Non-ulcerated stenosis |   |
Surface involved
by disease |   40% lesion80% lesion | | Surface involved
by ulcerations |   16% involvment22% involvment |
References
- Mary JY, Modigliani R. Development and validation of an endoscopic index of the severity for Crohn's disease: a prospective multicentre study. Gut 1989; 30 (7): 983-989.
- Sipponen T, Savilahti E, Kolho KL, Nuutinen H, Turunen U, Färkkilä M. Crohn’s Disease Activity Assessed by Fecal Calprotectin and Lactoferrin: Correlation with Crohn’s Disease Activity Index and Endoscopic Findings. Inflamm Bowel Dis 2008; 14 (1): 40-46.
