Ischemic colitis spans a broad spectrum from self-limiting illness to intestinal gangrene and mortality.
Prognostic factors specifically for nonpostoperative Ischemic colitis were not fully characterized.
Dr Tsung-Chun Lee and colleagues from Taiwan focused on nonpostoperative Ischemic colitis in patients with renal dysfunction, and identified prognostic factors for adverse outcomes.
The research team conducted a retrospective analysis at a university-affiliated tertiary medical center in Taiwan.
From 2003 to 2008, 25 men and 52 women had colonoscopic biopsy-proven Ischemic colitis without prior culprit surgery.
The researchers estimated glomerular filtration rate with simplified modification of diet in renal disease equation.
The team classified 9 patients with glomerular filtration rate below 30 mL per minute per 1.73 m2 as a renal dysfunction group.
Adverse outcomes were defined as need for surgery and mortality.
|Male sex conveyed a 10-fold risk for adverse outcomes|
|Journal of Clinical Gastroenterology|
Predictors for adverse outcomes were captured by univariate and multivariate analysis.
Patients with renal dysfunction more often had diabetes mellitus, prolonged symptom, lower hemoglobin, and more often right colonic involvement.
Renal dysfunction patients also had longer hospitalization days.
The team observed no statistical significance in the rate of either surgery or mortality between these 2 groups.
Univariate analysis showed that renal dysfunction, sex, emergency department referral, and presentation with abdominal pain were significant for adverse outcome.
Multivariate analysis revealed that male sex conveyed a 10-fold risk, and renal dysfunction conveyed 9-fold risk for adverse outcomes.
Dr Lee's team concluded, “Nonpostoperative Ischemic colitis patients with concurrent renal dysfunction had distinct clinical profiles.”
“Multivariate analysis showed that male patients had 9.5-fold and renal dysfunction patients had 8.5-fold increased risk for adverse outcomes.”
“Although Ischemic colitis is often self-limited, our data warrants special attention and aggressive therapy in treating these patients.”