Older patients are significantly more likely to have colon ischaemia‐associated conditions that are chronic and complex

Abstract

Background: Colon ischaemia is a common disease which has been associated with various medications and comorbidities.Aim: To test the hypothesis that there are differences in the frequencies of these associations in older compared with younger patients. Methods:A retrospective cohort study was performed of patients hospitalized with colon ischaemia at two major medical centres from 2005-2017. Clinical, colonoscopic and pathologic criteria were used to identify patients admitted with colon ischaemia; patients with other types of colitis were excluded. Demographic and medical data were extracted. Two cohorts were created: patients aged 18-64 years and patients > 65 years. These were compared using SAS 14.3. Results:A total of 788 patients were included, of which 271 (34.4%) were of ages 18-64 years, and 517 (66.6%) were 65 years old or older. In the older cohort, constipation-inducing medications (83.8% vs 64.1%; P = <0.0001), diuretics (38.1% vs 25.1%; P = <0.001) and nonsteroidal anti-inflammatory drugs (58% vs 41.5%; P = <0.0001) were more common than in the younger cohort. Antipsychotic medication use was more common in the younger cohort (10.4% vs 5.4%; P = 0.01). There was a higher percentage of younger patients with a history of hypercoaguable state (1.9% vs 0.2%; P = 0.03) and dialysis dependence (22.9% vs 8.7%; P = <0.01), while a higher percentage of patients in the older cohort had a history of chronic obstructive pulmonary disease (12% vs 6.3%; P = 0.01) or atrial fibrillation (18.9% vs 10.3%; P = <0.01). Conclusions:Our study shows that older patients are more likely to have colon ischaemia-associated conditions that are chronic and complex, while younger patients are more likely to have acute colon ischaemia-associated conditions. | 1503 SILVERMAN Et AL.

Idiopathic myointimal hyperplasia of the mesenteric veins: A systematic review and individual patient data regression analysis

“…The patients were derived from two large academic centers (Yale New Haven Hospital and Montefiore Medical Center) and clinical, endoscopic, and pathologic data were obtained for each patient. Details of this cohort have previously been reported 11 …”

“…Details of this cohort have previously been reported. 11 Statistical analysis. For descriptive analysis, we reported means and standard deviations for continuous variables and percentages for dichotomized variables unless otherwise specified.…”

Editorial: older patients are significantly more likely to have colon ischaemia‐associated conditions that are chronic and complex—authors' reply

“…We appreciate and agree with the comments of Drs Feuerstein and Clarke . The main purpose of our article was to highlight major differences in associated comorbidities and medications in younger and older populations with colon ischaemia . Such associations have been studied in the past and our contribution to this literature was to try and clarify any possible relationships by only including patients who had complete evaluations of their colons and biopsy proof of ischaemic injury.…”

Editorial: older patients are significantly more likely to have colon ischaemia‐associated conditions that are chronic and complex

“…Silverman et al presented data from 788 adult patients collected over 13 years at two medical centres in the United States . They found that approximately one‐third of patients admitted to hospital with colonic ischaemia were aged 18‐64 while the other two‐thirds were over 65.…”

“…While Silverman et al presented important data on medication associations with colonic ischaemia, their data need to be taken in the context of their study . This was a retrospective study using ICD‐9 and ICD‐10 coding to establish a diagnosis of ischaemic colitis.…”