Ischemic colitis: Spectrum of disease and outcome

The aim of this study was to identify risk factors, clinical characteristics, and outcome of patients with colon ischemia. A 10-year (1992-2002) retrospective study was undertaken. Patients were identified from computerized hospital discharge information. Patient variables were entered into a comput...

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Bibliographic Details
Published in:Surgery 2003-10, Vol.134 (4), p.624-629
Main Authors: Scharff, James R, Longo, Walter E, Vartanian, Shant M, Jacobs, Donald L, Bahadursingh, Anil N, Kaminski, Donald L
Format: Article
Language:English
Subjects:
Abdomen, Acute - etiology
Adult
Aged
Aged, 80 and over
Arteriosclerosis - etiology
Colitis, Ischemic - complications
Colitis, Ischemic - mortality
Colitis, Ischemic - therapy
Female
Humans
Kidney Failure, Chronic - etiology
Male
Melena - etiology
Middle Aged
Retrospective Studies
Survival Analysis
Treatment Outcome
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Summary:The aim of this study was to identify risk factors, clinical characteristics, and outcome of patients with colon ischemia. A 10-year (1992-2002) retrospective study was undertaken. Patients were identified from computerized hospital discharge information. Patient variables were entered into a computerized database and analyzed. One hundred twenty-nine patients were identified. The mean age was 66 years (range, 29-98 years); 47% were male. Forty-three patients (33%) had chronic renal failure; 73 patients (57%) were receiving vasoactive drugs, and 72 patients (56%) had atherosclerosis. Fifty-four of 129 patients (42%) had ischemic colitis in-hospital. Fifty-six of 129 patients (43%) had melena; 49 of 56 patients (88%) survived. Forty-three of 129 patients (33%) had an acute abdomen; 22 of 43 patients (51%) died. Seventy of 129 patients (54%) were treated nonoperatively initially; the condition of 17 of 70 patients (24%) required surgery. Of 76 patients who were treated operatively, 31 patients (41%) died. Eleven patients at operation had ischemia without colon infarction or perforation; 5 of these patients (45%) died. The overall mortality rate was 29% (37/129 patients). Ischemic colitis is associated with chronic renal failure and atherosclerosis. Patients commonly have an acute abdomen. The absence of colonic infarction does not ensure a favorable outcome. Patients who are felt to be candidates for nonoperative therapy have significant mortality rates. Mortality rates remain high, despite treatment.
ISSN:0039-6060
1532-7361
DOI:10.1016/S0039-6060(03)00308-8