Pediatric Ulcerative Colitis Activity Index (PUCAI)

ITEM / POINTS
1. Abdominal pain:
No pain
Pain can be ignored
Pain cannot be ignored / 0
5
10
2. Rectal bleeding
None
Small amount only, in less than 50% of stools
Small amount with most stools
Large amount (>50% of the stool content) / 0
10
20
30
3. Stool consistency of most stools
Formed
Partially formed
Completely unformed / 0
5
10
4. Number of stools per 24 hours
0-2
3-5
6-8
8 / 0
5
10
15
5. Nocturnal bowel movement (any diarrhea episode causing wakening)
No
Yes / 0
10
6. Activity level
No limitation of activity
Occasional limitation of activity
Severe restricted activity / 0
5
10
SUM OF PUCAI (0-85)


PUCAI user guide

Most items contained in the PUCAI can be scored using the instructions provided within the instrument. The following issues require additional clarification.

Time period for evaluation

·  Answers should reflect a daily average of the last two days.

·  However, if clinical conditions are changing rapidly (e.g. during intense intravenous therapy), the previous 24 hours should be considered.

·  For patients undergoing colonoscopy, answers should reflect the two days before bowel cleanout was started.

Activity level

·  Occasional limitation of activity= could attend school or equivalent, but reduced activity (e.g. attends school but does not play at breaks).

·  Severe restricted activity=could not attend school or equivalent activity.

PUCAI definitions of disease activity, remission, and response to therapy (all are based on analysis of data generated during development process during 2006)

·  Remission: total score less than 10 points

·  Mild disease activity: total score between 10 and 30 points inclusive

·  Moderate disease activity: total score between 35 and 60 points inclusive

·  Severe disease activity: total score of 65 points or greater

·  Response (minimal clinically significant change in score over time): a change in score of at least 20 points.