Ratib Mahfouz1, Landon A Kozai2, Adham E Obeidat3, Mohammad Darweesh4, Mahmoud M Mansour5, Mustafa F Douglas6, Eric Berthiaume7. 1. Internal Medicine, Kent Hospital/Brown University, Warwick, USA. 2. Internal medicine, University of Hawaii, Honolulu, USA. 3. Internal Medicine, University of Hawaii, Honolulu, USA. 4. Internal Medicine, East Tennessee State University, Johnson City, USA. 5. Internal Medicine, University of Missouri School of Medicine, Columbia, USA. 6. Internal Medicine, Midwestern University Arizona College of Osteopathic Medicine, Sierra Vista, USA. 7. Gastroenterology, Kent Hospital/Brown Unviersity, Warwick, USA.
Abstract
INTRODUCTION: Ischemic colitis (IC) results from compromised blood flow to the colon. Risk factors include atrial fibrillation (A.Fib), peripheral artery disease (PAD), coronary artery disease (CAD), and congestive heart failure (CHF). However, few studies compared the mortality rate and colectomy between patients with IC with CHF and IC alone. OBJECTIVE: We aim to investigate the possibility of worse outcomes in patients with IC and CHF compared to IC alone. METHODOLOGY: Using the National Inpatient Sample database from 2016 to 2019, we obtained baseline demographic data, total hospital charge, rate of colectomy, length of hospital stay (LOS), and in-hospital mortality. Data were compared using a t-test and chi-squared. Odds ratios for comorbidities including A.Fib, CAD, PAD, end-stage renal disease, chronic obstructive pulmonary disease, hyperlipidemia, hypertension, diabetes, and cirrhosis were calculated. RESULTS: 106,705 patients with IC were identified, among which 15,220 patients also had CHF. IC patients with CHF had a longer LOS (6.6 days vs 4.4 days; P<0.0001), higher total hospital charge ($71,359 vs $45,176; P<0.0001), higher mortality rate (8.5% vs 2.9%; P<0.0001), and higher colectomy rate (9.2% vs 5.9%; P<0.0001). CONCLUSION: CHF is associated with poor outcomes in patients with IC. Our study showed an increased risk of mortality and colectomy compared to patients with IC alone. The findings suggest it may be warranted to have a heightened clinical suspicion of IC in patients with CHF who present with bleeding per rectum.
INTRODUCTION: Ischemic colitis (IC) results from compromised blood flow to the colon. Risk factors include atrial fibrillation (A.Fib), peripheral artery disease (PAD), coronary artery disease (CAD), and congestive heart failure (CHF). However, few studies compared the mortality rate and colectomy between patients with IC with CHF and IC alone. OBJECTIVE: We aim to investigate the possibility of worse outcomes in patients with IC and CHF compared to IC alone. METHODOLOGY: Using the National Inpatient Sample database from 2016 to 2019, we obtained baseline demographic data, total hospital charge, rate of colectomy, length of hospital stay (LOS), and in-hospital mortality. Data were compared using a t-test and chi-squared. Odds ratios for comorbidities including A.Fib, CAD, PAD, end-stage renal disease, chronic obstructive pulmonary disease, hyperlipidemia, hypertension, diabetes, and cirrhosis were calculated. RESULTS: 106,705 patients with IC were identified, among which 15,220 patients also had CHF. IC patients with CHF had a longer LOS (6.6 days vs 4.4 days; P<0.0001), higher total hospital charge ($71,359 vs $45,176; P<0.0001), higher mortality rate (8.5% vs 2.9%; P<0.0001), and higher colectomy rate (9.2% vs 5.9%; P<0.0001). CONCLUSION: CHF is associated with poor outcomes in patients with IC. Our study showed an increased risk of mortality and colectomy compared to patients with IC alone. The findings suggest it may be warranted to have a heightened clinical suspicion of IC in patients with CHF who present with bleeding per rectum.
Authors: Siddhant Yadav; Maneesh Dave; Jithinraj Edakkanambeth Varayil; W Scott Harmsen; William J Tremaine; Alan R Zinsmeister; Seth R Sweetser; L Joseph Melton; William J Sandborn; Edward V Loftus Journal: Clin Gastroenterol Hepatol Date: 2014-08-12 Impact factor: 11.382
Authors: Marc D Samsky; Anne Hellkamp; William R Hiatt; F Gerry R Fowkes; Iris Baumgartner; Jeffrey S Berger; Brian G Katona; Kenneth W Mahaffey; Lars Norgren; Juuso I Blomster; Frank W Rockhold; Adam D DeVore; Manesh R Patel; W Schuyler Jones Journal: J Am Heart Assoc Date: 2021-05-31 Impact factor: 5.501