Clinical utility and outcome analysis of faecal calprotectin in Hawkes Bay District Health Board.

Abstract An audit to review the outcome in the use of faecal calprotectin (FCP) to differentiate irritable bowel syndrome (IBS) from active inflammatory bowel disease (IBD) patients, and to detect active flares in known IBD patients in the local Hawkes Bay District Health Board (HBDHB) population from October 2013 to October 2014. Retrospective review of all FCP specimens requested in the HBDHB region from October 2013 to October 2014. Their indication, final diagnosis from clinical records, and endoscopic results are reviewed. There were 104 FCP registrations during this period. They were ordered by gastroenterologists (67%), followed by medical specialists (31%), GPs (4%) and surgeons (2%). There were 85 FCP samples requested to differentiate IBS from active IBD. Thirty were diagnosed with IBS. The mean FCP level for the 30 patients was 27.23 mcg/g (range 14.1-41.4), which was exclusive of 50 mcg/g. Using the null value of 50 mcg/g from international studies, its p-value was <0.001. There were 19 FCP samples requested to detect a flare in known IBD patients. Seven patients were diagnosed with an active flare endoscopically. The mean FCP for the 7 patients was 378.4 mcg/g (range 275.1-481.8). This was exclusive of 250mcg/g. Using the null value of 250 from international studies, its p-value was 0.007). The use of FCP is effective to both differentiate IBS from active IBD patients, and to detect flares in known IBD patients in the HBDHB population.