Harvey-Bradshaw Index

Q: Harvey-Bradshaw Index (HBI) is a simplified derivative of which disease to determine the severity of disease?

A) Crohn's Disease Activity Index (CDAI) 
B) Severity of pneumonia index
C) ICU severity score
D) Mortality index from acute myocardial infarction
E) Post lung transplant mortality index


Answer: A

Harvey-Bradshaw Index (HBI) is a simplified derivative of the CDAI. It correlates well with CDAI. It can help ICU physicians to determine the level of urgency and choosing treatment modality. Calculators are easily available online.

Score of less than 5 on HBI is determined as clinical remission. HBI takes into account of

1. Patient sense of general well being in the last 24 hours
2. Patient report of abdominal pain in last 24 hours
3. Number of liquid stools in last 24 hours
4.  Finding of an abdominal mass
5.  Complications

CDAI is more extensive and complicated. It has four categories and takes into account

1. Patient reported stool pattern
2.  Average abdominal pain rating over seven days
3. General well being
4. Complications
5. Finding of an abdominal mass
6. Anemia and weight change

Severity goes up with score

1. Less than 150
2. Between 151 to 220
3. Between 221 to 450
4. Above 450 (Patients with severe symptoms despite glucocorticoids or biologic agents)


References:

1. Harvey RF, Bradshaw JM. A simple index of Crohn's-disease activity. Lancet 1980; 1:514.

2. Vermeire S, Schreiber S, Sandborn WJ, et al. Correlation between the Crohn's disease activity and Harvey-Bradshaw indices in assessing Crohn's disease severity. Clin Gastroenterol Hepatol 2010; 8:357.