Chronic obstructive pulmonary disease is associated with worse outcomes in ischemic colitis: a nationwide retrospective study.
COPD
Colectomy
Ischemic colitis
Mortality
National Inpatient Sample
Journal
International journal of colorectal disease
ISSN: 1432-1262
Titre abrégé: Int J Colorectal Dis
Pays: Germany
ID NLM: 8607899
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
accepted:
19
04
2021
pubmed:
15
5
2021
medline:
14
10
2021
entrez:
14
5
2021
Statut:
ppublish
Résumé
Ischemic colitis (IC) occurs when the blood supply of the large intestine becomes compromised. Several cardiovascular conditions, such as coronary artery disease, congestive heart failure, and atrial fibrillation, are well-established risk factors for the development of IC. The effects of pulmonary conditions, namely chronic obstructive pulmonary disease (COPD), on IC have not been well studied. Our aim was to elucidate if the presence of COPD worsened outcomes in patients with IC. Retrospective analysis of patients hospitalized with IC in 2016 was evaluated using the National Inpatient Sample database. Baseline demographic data, length of hospital stay (LOS), total hospital cost/charge, rates of colectomy, and in-hospital mortality were extracted from the database. Categorical variables were compared using the chi-square test and continuous variables were compared using the t-test. A total of 25,035 patients with IC were identified while 4482 of these patients also had COPD. We found that IC patients with COPD had a longer LOS (5.8 days vs 4.4 days; P<0.01), higher total hospital charge ($56,682 vs $42,365; P<0.01), higher total hospital cost ($13,603 vs $10,238; P<0.01), higher mortality rate (6.5% vs 3.1%; P<0.01), and higher colectomy rate (5.1% vs 3.7%; P<0.01). The presence of COPD portends poor outcomes in patients with IC. This was evidenced by increased risk of death and increased risk of undergoing colectomy. Given these findings, patients with COPD warrant closer observation. We advocate that COPD be considered as part of the risk assessment of patients with acute IC who need surgical intervention.
Sections du résumé
BACKGROUND
BACKGROUND
Ischemic colitis (IC) occurs when the blood supply of the large intestine becomes compromised. Several cardiovascular conditions, such as coronary artery disease, congestive heart failure, and atrial fibrillation, are well-established risk factors for the development of IC. The effects of pulmonary conditions, namely chronic obstructive pulmonary disease (COPD), on IC have not been well studied.
AIMS
OBJECTIVE
Our aim was to elucidate if the presence of COPD worsened outcomes in patients with IC.
METHODS
METHODS
Retrospective analysis of patients hospitalized with IC in 2016 was evaluated using the National Inpatient Sample database. Baseline demographic data, length of hospital stay (LOS), total hospital cost/charge, rates of colectomy, and in-hospital mortality were extracted from the database. Categorical variables were compared using the chi-square test and continuous variables were compared using the t-test.
RESULTS
RESULTS
A total of 25,035 patients with IC were identified while 4482 of these patients also had COPD. We found that IC patients with COPD had a longer LOS (5.8 days vs 4.4 days; P<0.01), higher total hospital charge ($56,682 vs $42,365; P<0.01), higher total hospital cost ($13,603 vs $10,238; P<0.01), higher mortality rate (6.5% vs 3.1%; P<0.01), and higher colectomy rate (5.1% vs 3.7%; P<0.01).
CONCLUSIONS
CONCLUSIONS
The presence of COPD portends poor outcomes in patients with IC. This was evidenced by increased risk of death and increased risk of undergoing colectomy. Given these findings, patients with COPD warrant closer observation. We advocate that COPD be considered as part of the risk assessment of patients with acute IC who need surgical intervention.
Identifiants
pubmed: 33987734
doi: 10.1007/s00384-021-03935-5
pii: 10.1007/s00384-021-03935-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2455-2461Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Brandt LJ (2015) Feuerstadt P, Longstreth GF, Boley SJ; American College of Gastroenterology. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastroenterol 110:18–45
doi: 10.1038/ajg.2014.395
Uchida T, Matsushima M, Orihashi Y, Dekiden-Monma M, Mizukami H, Nakahara F, Nakamura J, Fujisawa M, Koike J, Suzuki T, Mine T (2018) A case-control study on the risk factors for ischemic colitis. Tokai J Exp Clin Med 43:111–116
pubmed: 30191546
Brandt LJ, Feuerstadt P, Blaszka MC (2010) Anatomic patterns, patient characteristics, and clinical outcomes in ischemic colitis: a study of 313 cases supported by histology. Am J Gastroenterol 105:2245–2253
doi: 10.1038/ajg.2010.217
Moszkowicz D, Mariani A, Trésallet C, Menegaux F (2013) Ischemic colitis: the ABCs of diagnosis and surgical management. J Visc Surg 150:19–28
doi: 10.1016/j.jviscsurg.2013.01.002
Sherid M, Samo S, Sulaiman S, Husein H, Sethuraman SN, Vainder JA (2014) Is CT angiogram of the abdominal vessels needed following the diagnosis of ischemic colitis? A multicenter community study ISRN Gastroenterol 2014:756926
pubmed: 25089208
Higgins PD, Davis KJ, Laine L (2004) Systematic review: the epidemiology of ischaemic colitis. Aliment Pharmacol Ther 19:729–738
doi: 10.1111/j.1365-2036.2004.01903.x
Yadav S, Dave M, Edakkanambeth Varayil J, Harmsen WS, Tremaine WJ, Zinsmeister AR, Sweetser SR, Melton LJ III, Sandborn WJ, Loftus EV Jr (2015) A population-based study of incidence, risk factors, clinical spectrum, and outcomes of ischemic colitis. Clin Gastroenterol Hepatol 13:731–e41
doi: 10.1016/j.cgh.2014.07.061
Tseng J, Loper B, Jain M, Lewis AV, Margulies DR, Alban RF (2017) Predictive factors of mortality after colectomy in ischemic colitis: an ACS-NSQIP database study. Trauma Surg Acute Care Open 2:e000126
doi: 10.1136/tsaco-2017-000126
Trotter JM, Hunt L, Peter MB (2016) Ischaemic colitis. BMJ. 355:i6600
doi: 10.1136/bmj.i6600
Sherid M, Sifuentes H, Samo S, Sulaiman S, Husein H, Tupper R, Spurr C, Vainder J, Sridhar S (2014) Risk factors of recurrent ischemic colitis: a multicenter retrospective study. Korean J Gastroenterol 63:283–291
doi: 10.4166/kjg.2014.63.5.283
Sherid M, Sifuentes H, Samo S, Sulaiman S, Husein H, Tupper R, Sethuraman SN, Spurr C, Vainder JA, Sridhar S (2014) Ischemic colitis: a forgotten entity. Results of a retrospective study in 118 patients. J Dig Dis 15:606–613
doi: 10.1111/1751-2980.12182
Paterno F, McGillicuddy EA, Schuster KM, Longo WE (2010) Ischemic colitis: risk factors for eventual surgery. Am J Surg 200:646–650
doi: 10.1016/j.amjsurg.2010.07.005
Reissfelder C, Sweiti H, Antolovic D, Rahbari NN, Hofer S, Büchler MW, Weitz J, Koch M (2011) Ischemic colitis: who will survive? Surgery. 149:585–592
doi: 10.1016/j.surg.2010.11.008
Longstreth GF, Yao JF (2009) Epidemiology, clinical features, high-risk factors, and outcome of acute large bowel ischemia. Clin Gastroenterol Hepatol 7:1075–1023
doi: 10.1016/j.cgh.2009.05.026
Longstreth GF, Yao JF (2010) Diseases and drugs that increase risk of acute large bowel ischemia. Clin Gastroenterol Hepatol 8:49–54
doi: 10.1016/j.cgh.2009.09.006
Cubiella Fernández J, Núñez Calvo L, González Vázquez E, García García MJ, Alves Pérez MT, Martínez Silva I, Fernández Seara J (2010) Risk factors associated with the development of ischemic colitis. World J Gastroenterol 16:4564–4569
doi: 10.3748/wjg.v16.i36.4564
Huerta C, Rivero E, Montoro MA, García-Rodriguez LA (2011) Risk factors for intestinal ischaemia among patients registered in a UK primary care database: a nested case-control study. Aliment Pharmacol Ther 33:969–978
doi: 10.1111/j.1365-2036.2011.04614.x
Sherid M, Samo S, Sulaiman S, Husein H, Sethuraman SN, Thiruvaiyaru D, Spurr C, Sifuentes H, Sridhar S (2016) Comparison of ischemic colitis in the young and the elderly. WMJ. 115:196–202
pubmed: 29099157
Castleberry AW, Turley RS, Hanna JM, Hopkins TJ, Barbas AS, Worni M, Mantyh CR, Migaly J (2013) A 10-year longitudinal analysis of surgical management for acute ischemic colitis. J Gastrointest Surg 17:784–792
doi: 10.1007/s11605-012-2117-x
Flobert C, Cellier C, Berger A, Ngo A, Cuillerier E, Landi B, Marteau P, Cugnenc PH, Barbier JP (2000) Right colonic involvement is associated with severe forms of ischemic colitis and occurs frequently in patients with chronic renal failure requiring hemodialysis. Am J Gastroenterol 95:195–198
doi: 10.1111/j.1572-0241.2000.01644.x
Theodoropoulou A, Koutroubakis IE (2008) Ischemic colitis: clinical practice in diagnosis and treatment. World J Gastroenterol 14:7302–7308
doi: 10.3748/wjg.14.7302
Arif R, Farag M, Zaradzki M, Reissfelder C, Pianka F, Bruckner T, Kremer J, Franz M, Ruhparwar A, Szabo G, Beller CJ, Karck M, Kallenbach K, Weymann A (2016) Ischemic colitis after cardiac surgery: can we foresee the threat? PLoS One 11:e0167601
doi: 10.1371/journal.pone.0167601
HCUP National Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP) 2012 Agency for Healthcare Research and Quality, Rockville, MD
Kermani R, Coury JJ Jr, Dao H et al (2013) A practical mortality risk score for emergent colectomy. Dis Colon Rectum 56:467–474
doi: 10.1097/DCR.0b013e31827d0f93
Kimura T, Shinji A, Horiuchi A, Tanaka N, Nagaya T, Shigeno T, Nakamura N, Komatsu M, Umemura T, Arakura N, Matsumoto A, Tanaka E (2012) Clinical characteristics of young-onset ischemic colitis. Dig Dis Sci 57:1652–1659
doi: 10.1007/s10620-012-2088-5
Corlateanu A, Covantev S, Mathioudakis AG, Botnaru V, Siafakas N (2016) Prevalence and burden of comorbidities in chronic obstructive pulmonary disease. Respir Investig 54:387–396
doi: 10.1016/j.resinv.2016.07.001