Quantifying risk factors for ischemic colitis: A nationwide, retrospective cohort study

Twohig, Patrick; Desai, Aakash; Skeans, Jacob; Waghray, Nisheet

doi:10.1007/s12664-020-01049-4

Cited by 8 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionsupporting

confidence: 91%

“…Consistent with previous studies, we found a history of hypertension to be a risk factor for severe CI [15,24,25]. Chronically, high blood pressure has been identified to impair the function of the vascular endothelium, by leading to an increase in vascular tone, which could result in ischemia of organs [15,26]. Even though no systematic studies have established the association between CI and cardiovascular pathology, the association between hypertension and ischemic changes in the large intestine may be inferred in this context.…”

Section: Discussionsupporting

confidence: 90%

“…There are no standard diagnostic criteria for CI; hence, one of the main challenges is reaching an early diagnosis. Additionally, the clinical course of CI varies such that some patients recover with conservative management only, whereas others may need surgical treatment owing to the extensive necrosis or perforation of the colon [5,7,8,[14][15][16]. Thus, it is important to set up an early treatment plan after diagnosis by identifying poor prognostic factors associated with the severe outcomes of CI.…”

Section: Discussionmentioning

confidence: 99%

“…There are several studies that identified prognostic factors for severe CI including elevated lactate dehydrogenase, hypoalbuminemia, advanced age, tachycardia, hypotension at an early stage, involvement of the right colon, history of hypertension, diabetes mellitus, coronary artery disease, and chronic kidney disease requiring hemodialysis [15,[17][18][19][20][21][22]. To date, only two studies have developed a predictive scoring model for adverse outcomes in patients diagnosed with CI [4,23].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Development and Validation of a Risk Scoring Model for Early Prediction of Severe Colon Ischemia

et al. 2020

View full text Add to dashboard Cite

Background Colon ischemia (CI) is injury to the intestines secondary to insufficient blood flow. Its clinical severity can range from mild to life-threatening. Aims To investigate predictive risk factors for CI and propose a scoring model for severe outcomes. Methods We retrospectively analyzed the medical records of patients admitted to Chungnam National University Hospital from January 2010 to December 2018. CI was defined as severe when patients required surgery immediately or after initial conservative management, death occurred after hospitalization, or symptoms persisted after 2 weeks. By controlling for possible confounders from the logistic regression analysis, we obtained a new risk scoring model for the early prediction of severe CI. Furthermore, using the area under the receiver operating characteristics curve (AUROC), we assessed the accuracy of the model. Results A total of 274 patients endoscopically diagnosed with CI were included, of whom 181 had severe CI. In the multivariate analysis, tachycardia, elevated C-reactive protein, Favier endoscopic classification stage ≥ 2, and history of hypertension were independently and significantly associated with severe CI. The AUROC of the model was 0.749. Conclusions This risk scoring model based on the presence of tachycardia, elevated C-reactive protein level, unfavorable endoscopic findings by Favier's classification, and the history of hypertension could be used to predict severe CI outcomes at an early stage.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Development and Validation of a Risk Scoring Model for Early Prediction of Severe Colon Ischemia

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In the literature on pharmacological causes of colonic ischemia, psychotropic medications, NSAIDs, digitalis, agents that cause constipation or diarrhea, hormones, and tumor necrosis factor-alpha inhibitors had the strongest associations with IC ( 16 ). A national cohort study showed that β-blockers, opioids, and NSAIDs increase the risk of IC ( 17 ). In this study, the most commonly used drugs for patients before admission included NSAIDs, β-blockers, calcium channel blockers, and angiotensin receptor blockers.…”

Section: Discussionmentioning

confidence: 99%

A Novel Multiparameter Scoring Model for Noninvasive Early Prediction of Ischemic Colitis: A Multicenter, Retrospective, and Real-World Study

Luo

Wang

et al. 2021

Clin Transl Gastroenterol

View full text Add to dashboard Cite

INTRODUCTION: Ischemic colitis (IC) is a common gastrointestinal ischemic disease caused by hypoperfusion or reperfusion injury. However, there are few studies on risk factors associated with poor prognoses of the disease. This study aimed to determine the predictors of poor prognoses in patients with IC and establish a prognostic scoring method with good internal and external validity for identifying severe cases in an early stage. METHODS: We established a prognosis model by conducting a multicenter, retrospective study of patients hospitalized with IC between November 2008 and May 2020. Predictive power was tested using 5-fold internal cross-validation and external validation. RESULTS: The following 6 factors were included in the prognostic model: neutrophil count, D-dimer level, ischemia of the distal ileum, ischemia of the hepatic flexure, ulceration, and luminal stenosis. The area under the receiver-operating characteristic curve for internal cross-validation of the prediction model was 86%, and that for external validation was 95%. During internal validation, our model correctly identified 88.08% of the patients. It was further found that patients younger than 65 years with a higher neutrophil-to-lymphocyte ratio and higher heart rate had poor prognoses. Patients aged 65 years and older with ischemia of terminal ileum, hepatic flexure, splenic flexure, and intestinal stenosis had poor prognoses. DISCUSSION: Patients with ischemia in the hepatic flexure and the distal ileum, endoscopic evidence of ulcer or stenosis, higher neutrophil counts, and higher D-dimer levels have worse prognoses. This information could aid in the selection of timely and appropriate treatment.

show abstract

Indian Journal of Gastroenterology July–August 2020

Limdi

2020

Indian J Gastroenterol

View full text Add to dashboard Cite

Quantifying risk factors for ischemic colitis: A nationwide, retrospective cohort study

Cited by 8 publications

References 21 publications

Development and Validation of a Risk Scoring Model for Early Prediction of Severe Colon Ischemia

Development and Validation of a Risk Scoring Model for Early Prediction of Severe Colon Ischemia

A Novel Multiparameter Scoring Model for Noninvasive Early Prediction of Ischemic Colitis: A Multicenter, Retrospective, and Real-World Study

Indian Journal of Gastroenterology July–August 2020

Contact Info

Product

Resources

About