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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Pediatric Crohn’s Disease Activity Index (PCDAI)

    Stratifies severity of Crohn’s disease in pediatric patients.

    INSTRUCTIONS

    Use in patients ≤19 years old.

    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients ≤19 years old with confirmed diagnosis of Crohn’s disease.
    • Can be used in initial or follow-up visits to assess and track severity.
    • The Pediatric Crohn’s Disease Activity Index (PCDAI) was developed to stratify severity of Crohn’s disease in pediatric patients.
    • Maximum possible score is 100, and each decrease in score by 12.5 points indicates clinically significant response to therapy.
    • Symptom scores are based on recall from the previous week.
    • Calculate weight based on previous measurement at least 4–6 months earlier.
    • Perianal skin tags alone do not add to the “Perirectal disease” component of the score. There must be additional findings such as drainage, tenderness, or fistula.
    • Height is scored differently for initial visits versus follow-up visits. At initial visit, height should be compared against percentile prior to the onset of symptoms. On follow-up, height velocity should be calculated based on a value from the previous 6–12 months.
    • Combines essential subjective information, examination findings, and labs into a single score.
    • Commonly used in research to help assess treatment outcomes.
    History: Based on recall from the previous week
    None
    0
    Mild: Does not interfere with activities
    +5
    Moderate/Severe: Daily, longer lasting, affects activities, nocturnal
    +10
    0–1 liquid stools, no blood
    0
    2-5 liquid or ≤2 semi-formed with small blood
    +5
    ≥6 liquid, gross blood, or nocturnal diarrhea
    +10
    Well (no limitation of activities)
    0
    Below par (occasional difficulty in maintaining age-appropriate activities)
    +5
    Very poor (frequent limitation of activity)
    +10
    Examination
    Weight gain, weight voluntarily stable, or voluntary weight loss
    0
    Weight involuntarily stable or weight loss 1–9%
    +5
    Weight loss ≥10%
    +10
    <1 channel decrease (or height velocity ≥ -1SD)
    0
    Channel decrease ≥1 and <2 (or height velocity <-1SD and >-2SD)
    +5
    ≥2 channel decrease (or height velocity ≤-2SD)
    +10
    No tenderness, no mass
    0
    Tenderness, or mass without tenderness
    +5
    Tenderness, involuntary guarding, or definite mass
    +10
    None or asymptomatic tags
    0
    1–2 indolent fistulae, scant drainage, and no tenderness
    +5
    Active fistula, drainage, tenderness, or abscess
    +10
    None
    0
    1
    +5
    ≥2
    +10
    Laboratory
    Male
    Female
    years
    %
    mm/hr
    g/dL

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Jeffrey Hyams

    About the Creator

    Jeffrey Hyams, MD, is a professor of pediatrics at the University of Connecticut School of Medicine. He currently serves on the Rome Committee, an international research organization that investigates the course and treatment of functional GI disorders. Dr. Hyams' research focuses on pediatric digestive diseases, and he is a co-author of Pediatric Gastrointestinal and Liver Disease, now in its 5th edition.

    To view Dr. Jeffrey Hyams's publications, visit PubMed

    Are you Dr. Jeffrey Hyams? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Peter Townsend, MD
    About the Creator
    Dr. Jeffrey Hyams
    Are you Dr. Jeffrey Hyams?
    Content Contributors
    • Peter Townsend, MD