Risk Factors Associated with Progression to Surgery in Patients with Ischemic Colitis

Background/Aims: Ischemic colitis (IC), the most common ischemic syndrome affecting the gastrointestinal tract, results from a decreased blood supply to the colon. Persistent symptoms can lead to complications, necessitating surgery. This study assessed the clinical characteristics and risk factors...

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Main Authors: Je-Seong Kim, Ho-Jin Choi, Chan-Mook Im, Ga-Ram You, Young-Eun Seo, Chae-June Lim, Hyung-Hoon Oh, Young-Eun Joo
Format: Article
Language:English
Published: Jin Publishing & Printing Co. 2024-10-01
Series:The Korean Journal of Gastroenterology
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Online Access:https://www.kjg.or.kr/journal/view.html?uid=6053&vmd=Full
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author Je-Seong Kim
Ho-Jin Choi
Chan-Mook Im
Ga-Ram You
Young-Eun Seo
Chae-June Lim
Hyung-Hoon Oh
Young-Eun Joo
author_facet Je-Seong Kim
Ho-Jin Choi
Chan-Mook Im
Ga-Ram You
Young-Eun Seo
Chae-June Lim
Hyung-Hoon Oh
Young-Eun Joo
author_sort Je-Seong Kim
collection DOAJ
description Background/Aims: Ischemic colitis (IC), the most common ischemic syndrome affecting the gastrointestinal tract, results from a decreased blood supply to the colon. Persistent symptoms can lead to complications, necessitating surgery. This study assessed the clinical characteristics and risk factors for poor outcomes in IC. Methods: This retrospective observational study examined the medical records of 141 patients diagnosed pathologically with IC via surgery or colonoscopy at Chonnam National University Hwasun Hospital between April 2004 and August 2023. Results: Eighteen (12.8%) and 123 (87.2%) patients were diagnosed by surgical biopsy and biopsy with colonoscopy, respectively. Multivariate analysis identified right-sided colon involvement, fever, and the absence of hematochezia as risk factors for the progression to surgery (odds ratio [OR]=5.924, 95% confidence interval [CI] 1.009–34.767, p=0.049; OR=24.139, 95% CI 5.209–111.851, p<0.001; and OR=0.076, 95% CI 0.013–0.446, p=0.004, respectively). The in-hospital mortality was 5.7% (8/141), and the patients who died exhibited higher rates of shock. The median (interquartile range) hospital stay was 11 (1–219) days. Patients who had longer hospital stays (≥14 days) had a significantly higher rate of fever but a lower rate of hematochezia. Conclusions: A multidisciplinary approach is crucial for determining the need for surgery in patients with right-sided colon involvement, fever, or the absence of hematochezia.
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series The Korean Journal of Gastroenterology
spelling doaj-art-688e19b1d68c499fabf0d861c8b111ff2025-08-20T02:52:02ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922233-68692024-10-0184416016710.4166/kjg.2024.055Risk Factors Associated with Progression to Surgery in Patients with Ischemic ColitisJe-Seong Kim0Ho-Jin Choi1Chan-Mook Im2Ga-Ram You3Young-Eun Seo4Chae-June Lim5Hyung-Hoon Oh 6Young-Eun Joo7https://orcid.org/0000-0003-0422-2439Department of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaBackground/Aims: Ischemic colitis (IC), the most common ischemic syndrome affecting the gastrointestinal tract, results from a decreased blood supply to the colon. Persistent symptoms can lead to complications, necessitating surgery. This study assessed the clinical characteristics and risk factors for poor outcomes in IC. Methods: This retrospective observational study examined the medical records of 141 patients diagnosed pathologically with IC via surgery or colonoscopy at Chonnam National University Hwasun Hospital between April 2004 and August 2023. Results: Eighteen (12.8%) and 123 (87.2%) patients were diagnosed by surgical biopsy and biopsy with colonoscopy, respectively. Multivariate analysis identified right-sided colon involvement, fever, and the absence of hematochezia as risk factors for the progression to surgery (odds ratio [OR]=5.924, 95% confidence interval [CI] 1.009–34.767, p=0.049; OR=24.139, 95% CI 5.209–111.851, p<0.001; and OR=0.076, 95% CI 0.013–0.446, p=0.004, respectively). The in-hospital mortality was 5.7% (8/141), and the patients who died exhibited higher rates of shock. The median (interquartile range) hospital stay was 11 (1–219) days. Patients who had longer hospital stays (≥14 days) had a significantly higher rate of fever but a lower rate of hematochezia. Conclusions: A multidisciplinary approach is crucial for determining the need for surgery in patients with right-sided colon involvement, fever, or the absence of hematochezia.https://www.kjg.or.kr/journal/view.html?uid=6053&vmd=Fullischemiacolonrisksurgery
spellingShingle Je-Seong Kim
Ho-Jin Choi
Chan-Mook Im
Ga-Ram You
Young-Eun Seo
Chae-June Lim
Hyung-Hoon Oh
Young-Eun Joo
Risk Factors Associated with Progression to Surgery in Patients with Ischemic Colitis
The Korean Journal of Gastroenterology
ischemia
colon
risk
surgery
title Risk Factors Associated with Progression to Surgery in Patients with Ischemic Colitis
title_full Risk Factors Associated with Progression to Surgery in Patients with Ischemic Colitis
title_fullStr Risk Factors Associated with Progression to Surgery in Patients with Ischemic Colitis
title_full_unstemmed Risk Factors Associated with Progression to Surgery in Patients with Ischemic Colitis
title_short Risk Factors Associated with Progression to Surgery in Patients with Ischemic Colitis
title_sort risk factors associated with progression to surgery in patients with ischemic colitis
topic ischemia
colon
risk
surgery
url https://www.kjg.or.kr/journal/view.html?uid=6053&vmd=Full
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