Risk factors in toxic megacolon.

A retrospective analysis of data from a series of 22 patients with toxic megacolon complicating ulcerative colitis was performed in an attempt to detect factors associated with the fatal outcome of the attack. Of the 25 clinical findings studied, significant differences between survivors (17) and nonsurvivors (5) were observed in only seven. In nonsurvivors, duration of the disease was longer and blood pH and standard bicarbonate levels higher, whereas serum potassium, calcium, phosphorus, and beta-globulins were lower. Discriminant analysis showed that three pairs of features, namely potassium-beta-globulins, potassium-bicarbonate, and potassium-blood pH provided a good discrimination between survivors and nonsurvivors. Results of this study indicate that the severity of the electrolyte and metabolic disorder appears to be an important risk factor in toxic megacolon. Intensive fluid and electrolyte replacement should therefore be considered a crucial point for successful management of toxic megacolon.