Acute Colonic Pseudo-obstruction: Defining the Epidemiology, Treatment, and Adverse Outcomes of Ogilvie's Syndrome

Acute colonic pseudo-obstruction (ACPO) is a rare but often fatal disease. Herein, we present the largest study to date on ACPO. The National Inpatient Sample was queried for ACPO diagnoses from 1998 to 2011. Patients were analyzed by treatment into four groups: medical management (MM), colonoscopy...

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Bibliographic Details
Published in:The American surgeon 2016-02, Vol.82 (2), p.102-111
Main Authors: Ross, Samuel W., Oommen, Bindhu, Wormer, Blair A., Walters, Amanda L., Augenstein, Vedra A., Heniford, B. Todd, Sing, Ronald F., Christmas, A. Britton
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Clinical outcomes
Codes
Colectomy
Colonic Pseudo-Obstruction - complications
Colonic Pseudo-Obstruction - diagnosis
Colonic Pseudo-Obstruction - epidemiology
Colonic Pseudo-Obstruction - therapy
Colonoscopy
Combined Modality Therapy
Comorbidity
Endoscopy
Epidemiology
Female
Hospitals
Humans
Intervention
Logistic Models
Male
Metastasis
Middle Aged
Morbidity
Mortality
Multivariate analysis
Patients
Retrospective Studies
Risk factors
Surgery
Treatment Outcome
United States - epidemiology
Young Adult
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Summary:Acute colonic pseudo-obstruction (ACPO) is a rare but often fatal disease. Herein, we present the largest study to date on ACPO. The National Inpatient Sample was queried for ACPO diagnoses from 1998 to 2011. Patients were analyzed by treatment into four groups: medical management (MM), colonoscopy alone [(endoscopy-only group) ENDO], surgery alone (SURG), or surgery and colonoscopy (SAC). Logistic regression was used to identify predictors of adverse outcomes by treatment group. There were 106,784 cases of ACPO: 96,657 (90.5%) MM, 2,915 (2.7%) ENDO, 6,731 (6.3%) SURG, and 481 (0.5%) SAC. The medical complication (45.7%), procedural complication (15.9%), and mortality rates (7.7%) were high. Increasing procedure invasiveness was independently associated with higher odds of medical complications, procedural complications, and death (P < 0.0125). The odds of death were significantly higher in the ENDO [odds ratio (OR) = 1.2], SURG (OR 1.4), and SAC (OR = 1.8) groups (P < 0.0125). Those who fail MM and require procedures have increasing morbidity and mortality with increasing invasiveness, likely reflecting the severity of their conditions.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481608200211