Outcomes of patients with ischemic colitis causing severe hematochezia managed medically or surgically
Purpose To compare short- and long-term outcomes of hospitalized patients with ischemic colitis (IC) presenting with severe hematochezia and treated medically or colectomy and also those with inpatient vs. outpatient start of hematochezia. Methods A retrospective analysis of prospectively collected...
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| Veröffentlicht in: | Langenbeck's archives of surgery 2022-06, Vol.407 (4), p.1625-1636 |
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| creator | Wongpongsalee, Thongsak Khrucharoen, Usah Jensen, Dennis M. Jutabha, Rome Jensen, Mary Ellen Thibodeau, Gail |
| description | Purpose
To compare short- and long-term outcomes of hospitalized patients with ischemic colitis (IC) presenting with severe hematochezia and treated medically or colectomy and also those with inpatient vs. outpatient start of hematochezia.
Methods
A retrospective analysis of prospectively collected data for IC patients hospitalized for severe hematochezia from two teaching hospitals was done from 1994 to 2020, with the diagnosis of IC made colonoscopically and confirmed histologically.
Results
Ninety-seven patients initially all had medical management for IC. Seventy-two (74.2%) were stable and had no further bleeding; 17 (17.5%) had colon resection; and 8 were critically ill and not surgical candidates. Surgical patients and non-surgical candidate had higher comorbidity scores; received more red blood cell (RBC) transfusion (median (IQR) 5 (3–10) vs. 4.5 (3–6.5) vs. 1 (0–4) units,
p
|
| doi_str_mv | 10.1007/s00423-022-02441-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2631642577</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2631642577</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-de13762c6a628938d33e4eaa0da05b1fe8165c33fc54bff5e9a8319dd469acc93</originalsourceid><addsrcrecordid>eNp9kD1PwzAURS0EoqXwBxiQR5aAv5OMqOJLqtQFZst1XlpXSVzsBAS_HkMKYmKwbOudd6V7EDqn5IoSkl9HQgTjGWEsHSFoVhygKRVcZkxIevjnPUEnMW4JISovxTGacEmLXJZkiurl0FvfQsS-xjvTO-j6iN9cv8Eu2g20zmLrG9e7iK0ZouvWOMIrBMBpaHqfmA9ncGs6s4YKt1A5a5rmHfuA4xDW4-8UHdWmiXC2v2fo-e72af6QLZb3j_ObRWa5yPusAspzxawyihUlLyrOQYAxpDJErmgNBVXScl5bKVZ1LaE0BadlVQlVGmtLPkOXY-4u-JcBYq_bVAOaxnTgh6iZ4lQJJvM8oWxEbfAxBqj1LrjWhHdNif7yq0e_OvnV3351kZYu9vnDKlX9XfkRmgA-AjGNujUEvfVD6FLn_2I_AfUuiBU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2631642577</pqid></control><display><type>article</type><title>Outcomes of patients with ischemic colitis causing severe hematochezia managed medically or surgically</title><source>Springer Nature - Complete Springer Journals</source><creator>Wongpongsalee, Thongsak ; Khrucharoen, Usah ; Jensen, Dennis M. ; Jutabha, Rome ; Jensen, Mary Ellen ; Thibodeau, Gail</creator><creatorcontrib>Wongpongsalee, Thongsak ; Khrucharoen, Usah ; Jensen, Dennis M. ; Jutabha, Rome ; Jensen, Mary Ellen ; Thibodeau, Gail</creatorcontrib><description>Purpose
To compare short- and long-term outcomes of hospitalized patients with ischemic colitis (IC) presenting with severe hematochezia and treated medically or colectomy and also those with inpatient vs. outpatient start of hematochezia.
Methods
A retrospective analysis of prospectively collected data for IC patients hospitalized for severe hematochezia from two teaching hospitals was done from 1994 to 2020, with the diagnosis of IC made colonoscopically and confirmed histologically.
Results
Ninety-seven patients initially all had medical management for IC. Seventy-two (74.2%) were stable and had no further bleeding; 17 (17.5%) had colon resection; and 8 were critically ill and not surgical candidates. Surgical patients and non-surgical candidate had higher comorbidity scores; received more red blood cell (RBC) transfusion (median (IQR) 5 (3–10) vs. 4.5 (3–6.5) vs. 1 (0–4) units,
p
< 0.001); had significantly longer hospital and ICU days; had higher severe complication rates (35.3% vs. 100%. vs. 5.6%,
p
< 0.001); and had higher 30-day all-cause mortality rates (23.5% vs. 87.5% vs. 0,
p
< 0.001). Inpatients developing IC hemorrhage had more RBC transfusions, more complications, longer hospital stays, and higher mortality than patients whose IC bleeding started as outpatients.
Conclusions
The majority of IC patients hospitalized for severe hematochezia were successfully treated medically. Patients who were not surgical candidate had the highest rates of severe complications and mortality. Surgical patients and those who were not surgical candidate had worse outcomes than the medical group. Patients with inpatient start of bleeding from IC had significantly worse outcomes than those with outpatient start of bleeding.</description><identifier>ISSN: 1435-2451</identifier><identifier>EISSN: 1435-2451</identifier><identifier>DOI: 10.1007/s00423-022-02441-8</identifier><identifier>PMID: 35187590</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdominal Surgery ; Cardiac Surgery ; General Surgery ; Medicine ; Medicine & Public Health ; Original Article ; Thoracic Surgery ; Traumatic Surgery ; Vascular Surgery</subject><ispartof>Langenbeck's archives of surgery, 2022-06, Vol.407 (4), p.1625-1636</ispartof><rights>This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2022</rights><rights>2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-de13762c6a628938d33e4eaa0da05b1fe8165c33fc54bff5e9a8319dd469acc93</citedby><cites>FETCH-LOGICAL-c347t-de13762c6a628938d33e4eaa0da05b1fe8165c33fc54bff5e9a8319dd469acc93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00423-022-02441-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00423-022-02441-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35187590$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wongpongsalee, Thongsak</creatorcontrib><creatorcontrib>Khrucharoen, Usah</creatorcontrib><creatorcontrib>Jensen, Dennis M.</creatorcontrib><creatorcontrib>Jutabha, Rome</creatorcontrib><creatorcontrib>Jensen, Mary Ellen</creatorcontrib><creatorcontrib>Thibodeau, Gail</creatorcontrib><title>Outcomes of patients with ischemic colitis causing severe hematochezia managed medically or surgically</title><title>Langenbeck's archives of surgery</title><addtitle>Langenbecks Arch Surg</addtitle><addtitle>Langenbecks Arch Surg</addtitle><description>Purpose
To compare short- and long-term outcomes of hospitalized patients with ischemic colitis (IC) presenting with severe hematochezia and treated medically or colectomy and also those with inpatient vs. outpatient start of hematochezia.
Methods
A retrospective analysis of prospectively collected data for IC patients hospitalized for severe hematochezia from two teaching hospitals was done from 1994 to 2020, with the diagnosis of IC made colonoscopically and confirmed histologically.
Results
Ninety-seven patients initially all had medical management for IC. Seventy-two (74.2%) were stable and had no further bleeding; 17 (17.5%) had colon resection; and 8 were critically ill and not surgical candidates. Surgical patients and non-surgical candidate had higher comorbidity scores; received more red blood cell (RBC) transfusion (median (IQR) 5 (3–10) vs. 4.5 (3–6.5) vs. 1 (0–4) units,
p
< 0.001); had significantly longer hospital and ICU days; had higher severe complication rates (35.3% vs. 100%. vs. 5.6%,
p
< 0.001); and had higher 30-day all-cause mortality rates (23.5% vs. 87.5% vs. 0,
p
< 0.001). Inpatients developing IC hemorrhage had more RBC transfusions, more complications, longer hospital stays, and higher mortality than patients whose IC bleeding started as outpatients.
Conclusions
The majority of IC patients hospitalized for severe hematochezia were successfully treated medically. Patients who were not surgical candidate had the highest rates of severe complications and mortality. Surgical patients and those who were not surgical candidate had worse outcomes than the medical group. Patients with inpatient start of bleeding from IC had significantly worse outcomes than those with outpatient start of bleeding.</description><subject>Abdominal Surgery</subject><subject>Cardiac Surgery</subject><subject>General Surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Thoracic Surgery</subject><subject>Traumatic Surgery</subject><subject>Vascular Surgery</subject><issn>1435-2451</issn><issn>1435-2451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAURS0EoqXwBxiQR5aAv5OMqOJLqtQFZst1XlpXSVzsBAS_HkMKYmKwbOudd6V7EDqn5IoSkl9HQgTjGWEsHSFoVhygKRVcZkxIevjnPUEnMW4JISovxTGacEmLXJZkiurl0FvfQsS-xjvTO-j6iN9cv8Eu2g20zmLrG9e7iK0ZouvWOMIrBMBpaHqfmA9ncGs6s4YKt1A5a5rmHfuA4xDW4-8UHdWmiXC2v2fo-e72af6QLZb3j_ObRWa5yPusAspzxawyihUlLyrOQYAxpDJErmgNBVXScl5bKVZ1LaE0BadlVQlVGmtLPkOXY-4u-JcBYq_bVAOaxnTgh6iZ4lQJJvM8oWxEbfAxBqj1LrjWhHdNif7yq0e_OvnV3351kZYu9vnDKlX9XfkRmgA-AjGNujUEvfVD6FLn_2I_AfUuiBU</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Wongpongsalee, Thongsak</creator><creator>Khrucharoen, Usah</creator><creator>Jensen, Dennis M.</creator><creator>Jutabha, Rome</creator><creator>Jensen, Mary Ellen</creator><creator>Thibodeau, Gail</creator><general>Springer Berlin Heidelberg</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20220601</creationdate><title>Outcomes of patients with ischemic colitis causing severe hematochezia managed medically or surgically</title><author>Wongpongsalee, Thongsak ; Khrucharoen, Usah ; Jensen, Dennis M. ; Jutabha, Rome ; Jensen, Mary Ellen ; Thibodeau, Gail</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-de13762c6a628938d33e4eaa0da05b1fe8165c33fc54bff5e9a8319dd469acc93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal Surgery</topic><topic>Cardiac Surgery</topic><topic>General Surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Thoracic Surgery</topic><topic>Traumatic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wongpongsalee, Thongsak</creatorcontrib><creatorcontrib>Khrucharoen, Usah</creatorcontrib><creatorcontrib>Jensen, Dennis M.</creatorcontrib><creatorcontrib>Jutabha, Rome</creatorcontrib><creatorcontrib>Jensen, Mary Ellen</creatorcontrib><creatorcontrib>Thibodeau, Gail</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Langenbeck's archives of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wongpongsalee, Thongsak</au><au>Khrucharoen, Usah</au><au>Jensen, Dennis M.</au><au>Jutabha, Rome</au><au>Jensen, Mary Ellen</au><au>Thibodeau, Gail</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of patients with ischemic colitis causing severe hematochezia managed medically or surgically</atitle><jtitle>Langenbeck's archives of surgery</jtitle><stitle>Langenbecks Arch Surg</stitle><addtitle>Langenbecks Arch Surg</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>407</volume><issue>4</issue><spage>1625</spage><epage>1636</epage><pages>1625-1636</pages><issn>1435-2451</issn><eissn>1435-2451</eissn><abstract>Purpose
To compare short- and long-term outcomes of hospitalized patients with ischemic colitis (IC) presenting with severe hematochezia and treated medically or colectomy and also those with inpatient vs. outpatient start of hematochezia.
Methods
A retrospective analysis of prospectively collected data for IC patients hospitalized for severe hematochezia from two teaching hospitals was done from 1994 to 2020, with the diagnosis of IC made colonoscopically and confirmed histologically.
Results
Ninety-seven patients initially all had medical management for IC. Seventy-two (74.2%) were stable and had no further bleeding; 17 (17.5%) had colon resection; and 8 were critically ill and not surgical candidates. Surgical patients and non-surgical candidate had higher comorbidity scores; received more red blood cell (RBC) transfusion (median (IQR) 5 (3–10) vs. 4.5 (3–6.5) vs. 1 (0–4) units,
p
< 0.001); had significantly longer hospital and ICU days; had higher severe complication rates (35.3% vs. 100%. vs. 5.6%,
p
< 0.001); and had higher 30-day all-cause mortality rates (23.5% vs. 87.5% vs. 0,
p
< 0.001). Inpatients developing IC hemorrhage had more RBC transfusions, more complications, longer hospital stays, and higher mortality than patients whose IC bleeding started as outpatients.
Conclusions
The majority of IC patients hospitalized for severe hematochezia were successfully treated medically. Patients who were not surgical candidate had the highest rates of severe complications and mortality. Surgical patients and those who were not surgical candidate had worse outcomes than the medical group. Patients with inpatient start of bleeding from IC had significantly worse outcomes than those with outpatient start of bleeding.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35187590</pmid><doi>10.1007/s00423-022-02441-8</doi><tpages>12</tpages></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Cardiac Surgery General Surgery Medicine Medicine & Public Health Original Article Thoracic Surgery Traumatic Surgery Vascular Surgery |
| title | Outcomes of patients with ischemic colitis causing severe hematochezia managed medically or surgically |
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