BACKGROUND: Ischaemic colitis (IC) is the most common form of intestinal ischaemia with a wide spectrum of severity, with possible risk of death. OBJECTIVE: The purpose of this study was to evaluate predictive factors of in-hospital and short-term mortality, in a cohort of patients with IC. METHODS: Retrospective analysis of IC cases diagnosed between 2008-2013 in a single tertiary centre, with assessment of factors at the time of diagnosis associated with in-hospital and 90-day mortality. RESULTS: Of the 203 patients included (132 women), 47 (23%) died during the follow-up (median: 16 months). There were 21 patients (45%) who died during hospitalization and at 90 days there were 30 deaths (64% of total). In multivariate analysis, need for vasopressor support (odds ratio (OR) 11.21; 95% confidence interval (CI): 2.31-54.24; p = 0.01), Intermediate or Intensive Care Unit (ICU): admission (OR 7.01; 95% CI: 1.48-33.16; p = 0.014) and atrial fibrillation (OR 4.99; 95% CI: 1.1-26.23; p = 0.048) were independently and significantly associated with in-hospital mortality. Using the coefficients of the estimated logistic model, we calculated a scoring model to predict the occurrence of in-hospital mortality. The presence of all three risk factors predicted a probability of death of 32% with an area under the receiver operating characteristic curve (AUROC) of 0.89 (95% CI 0.80-0.98. At 90 days, the presence of chronic kidney disease (OR 7.46; 95% CI: 1.87-29.73; p = 0.002), and male sex (OR 5.85; 95% CI: 1.57-21.83; p = 0.009) were also independently associated with mortality. CONCLUSIONS: Most deaths in ischaemic colitis occur in the first 90 days after admission, sharing similar risk factors. Assessment of the presence of atrial fibrillation, need of vasopressor support or hospitalization in the intermediate/intensive care unit provides a useful tool to estimate in-hospital mortality and to establish the management for patients admitted for ischaemic colitis.
BACKGROUND:Ischaemic colitis (IC) is the most common form of intestinal ischaemia with a wide spectrum of severity, with possible risk of death. OBJECTIVE: The purpose of this study was to evaluate predictive factors of in-hospital and short-term mortality, in a cohort of patients with IC. METHODS: Retrospective analysis of IC cases diagnosed between 2008-2013 in a single tertiary centre, with assessment of factors at the time of diagnosis associated with in-hospital and 90-day mortality. RESULTS: Of the 203 patients included (132 women), 47 (23%) died during the follow-up (median: 16 months). There were 21 patients (45%) who died during hospitalization and at 90 days there were 30 deaths (64% of total). In multivariate analysis, need for vasopressor support (odds ratio (OR) 11.21; 95% confidence interval (CI): 2.31-54.24; p = 0.01), Intermediate or Intensive Care Unit (ICU): admission (OR 7.01; 95% CI: 1.48-33.16; p = 0.014) and atrial fibrillation (OR 4.99; 95% CI: 1.1-26.23; p = 0.048) were independently and significantly associated with in-hospital mortality. Using the coefficients of the estimated logistic model, we calculated a scoring model to predict the occurrence of in-hospital mortality. The presence of all three risk factors predicted a probability of death of 32% with an area under the receiver operating characteristic curve (AUROC) of 0.89 (95% CI 0.80-0.98. At 90 days, the presence of chronic kidney disease (OR 7.46; 95% CI: 1.87-29.73; p = 0.002), and male sex (OR 5.85; 95% CI: 1.57-21.83; p = 0.009) were also independently associated with mortality. CONCLUSIONS: Most deaths in ischaemic colitis occur in the first 90 days after admission, sharing similar risk factors. Assessment of the presence of atrial fibrillation, need of vasopressor support or hospitalization in the intermediate/intensive care unit provides a useful tool to estimate in-hospital mortality and to establish the management for patients admitted for ischaemic colitis.
Authors: Miguel A Montoro; Lawrence J Brandt; Santos Santolaria; Fernando Gomollon; Belén Sánchez Puértolas; Jesús Vera; Luis Bujanda; Angel Cosme; José Luis Cabriada; Margarita Durán; Laura Mata; Ana Santamaría; Gloria Ceña; Jose Manuel Blas; Julio Ponce; Marta Ponce; Luis Rodrigo; Jacobo Ortiz; Carmen Muñoz; Gloria Arozena; Daniel Ginard; Antonio López-Serrano; Manuel Castro; Miquel Sans; Rafael Campo; Alex Casalots; Víctor Orive; Alberto Loizate; Lluçia Titó; Eva Portabella; Pedro Otazua; M Calvo; Maria Teresa Botella; Concepción Thomson; Jose Luis Mundi; Enrique Quintero; David Nicolás; Fernando Borda; Benito Martinez; Javier P Gisbert; María Chaparro; Alfredo Jimenez Bernadó; Federico Gómez-Camacho; Antonio Cerezo; Enrique Casal Nuñez Journal: Scand J Gastroenterol Date: 2010-10-20 Impact factor: 2.423