María Del Rosario Pastor-Juan1, Tomás Ripollés2, Luis Martí-Bonmatí3, María Jesús Martínez4, Luis Simó5, Diana Gómez6, Rafael Revert7. 1. Department of Radiology, Complejo Hospitalario Universitario de Albacete, 37 Hermanos Falcó St., Albacete 02006, Spain. Electronic address: pastor_ros@hotmail.com. 2. Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Ave., Valencia 46017, Spain. Electronic address: ripolles_tom@gva.es. 3. Deparment of Radiology, Hospital Universitari i Politecnic La Fe, 106 Fernando Abril Martorell Ave., Valencia 46026, Spain. Electronic address: marti_lui@gva.es. 4. Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Ave., Valencia 46017, Spain. Electronic address: chusjmartinez@gmail.com. 5. Deparment of Radiology, Hospital Universitari Arnau de Vilanova, 12, Sant Clement St., Valencia 46015, Spain. Electronic address: luissimo58@hotmail.com. 6. Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Ave., Valencia 46017, Spain. Electronic address: dianapgv@gmail.com. 7. Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Ave., Valencia 46017, Spain. Electronic address: rafarevert86@gmail.com.
Abstract
PURPOSE: The main objective was to evaluate the usefulness of early ultrasonography for determining prognosis of patients with ischemic colitis. MATERIALS AND METHODS: We reviewed the histories of patients with diagnosis of ischemic colitis over a period of 11 years. Two hundred twenty nine patients with ischemic colitis were included. Demographic, clinical, laboratory and sonographic findings were retrospectively analyzed. Patients were divided into two groups according to the outcome: mild (those who improved with conservative treatment) or severe (those who died or required surgery), and the findings of each group were compared. In addition, we developed a predictive model of multivariate logistic regression analysis, and then it was validated in a different population of 58 consecutive patients with ischemic colitis. RESULTS: The mild ischemic colitis group consisted of 184 patients (age 74,7±8,8years), and the severe group of 45 patients (age 78,6±7,7years). More pancolitis (p=0.005), altered pericolic fat (p=0.032) and free fluid (p=0.013) was observed in the severe ischemic colitis group compared with the mild group. Severe ischemic group had lower wall thickness (p=0.020) and higher resistive index than mild group (p=0.025). Multivariate analysis identified as protective factors to severe ischemic colitis: pain (p=0.026), diarrhea (p=0.034), rectal bleeding (p=0.000), and hypertension (p=0.001). Altered pericolic fat (p=0.008) and pancolitis (p=0.017) were sonographic findings significantly related to severe ischemic colitis. Our model correctly classified 88.4% of the study patients and 89.6% of the population of 58 patients used in validation. CONCLUSIONS: Sonographic features with clinical findings can predict the outcome of ischemic colitis. Our predictive model could differentiate properly between patients with mild or severe ischemic colitis.
PURPOSE: The main objective was to evaluate the usefulness of early ultrasonography for determining prognosis of patients with ischemic colitis. MATERIALS AND METHODS: We reviewed the histories of patients with diagnosis of ischemic colitis over a period of 11 years. Two hundred twenty nine patients with ischemic colitis were included. Demographic, clinical, laboratory and sonographic findings were retrospectively analyzed. Patients were divided into two groups according to the outcome: mild (those who improved with conservative treatment) or severe (those who died or required surgery), and the findings of each group were compared. In addition, we developed a predictive model of multivariate logistic regression analysis, and then it was validated in a different population of 58 consecutive patients with ischemic colitis. RESULTS: The mild ischemic colitis group consisted of 184 patients (age 74,7±8,8years), and the severe group of 45 patients (age 78,6±7,7years). More pancolitis (p=0.005), altered pericolic fat (p=0.032) and free fluid (p=0.013) was observed in the severe ischemic colitis group compared with the mild group. Severe ischemic group had lower wall thickness (p=0.020) and higher resistive index than mild group (p=0.025). Multivariate analysis identified as protective factors to severe ischemic colitis: pain (p=0.026), diarrhea (p=0.034), rectal bleeding (p=0.000), and hypertension (p=0.001). Altered pericolic fat (p=0.008) and pancolitis (p=0.017) were sonographic findings significantly related to severe ischemic colitis. Our model correctly classified 88.4% of the study patients and 89.6% of the population of 58 patients used in validation. CONCLUSIONS: Sonographic features with clinical findings can predict the outcome of ischemic colitis. Our predictive model could differentiate properly between patients with mild or severe ischemic colitis.