A 10-year longitudinal analysis of surgical management for acute ischemic colitis.

Published

Journal Article

INTRODUCTION: Our objective was to review our 10-year experience of surgical resection for acute ischemic colitis (IC) and to assess the predictive value of previously reported risk-stratification methods. METHODS: We retrospectively reviewed all adult patients at our institution undergoing colectomy for acute IC between 2000 and 2009. Descriptive statistics were calculated. Long-term survival was assessed using Kaplan-Meier methods and in-hospital mortality using multivariate logistic regression. Patients were risk-stratified based on previously reported methods, and discriminatory accuracy of predicting in-hospital mortality was evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. RESULTS: A total of 115 patients were included for analysis, of which 37 % (n = 43) died in-hospital. The median survival was 4.9 months for all patients and 43.6 months for patients surviving to discharge. Seventeen patients subsequently underwent end-ostomy reversal at our institution, with in-hospital mortality of 18 % (n = 3) and ICU admission for 35 % (n = 6). The discriminatory accuracy of risk stratification in predicting in-hospital mortality based on ROC AUC was 0.75. CONCLUSION: Acute IC continues to remain a very deadly disease. Patients who survive the initial acute IC insult can achieve long-term survival; however, we experienced high rates of death and complications following elective end-ostomy reversal. Risk stratification provides reasonable accuracy in predicting postoperative mortality.

Full Text

Duke Authors

Cited Authors

  • Castleberry, AW; Turley, RS; Hanna, JM; Hopkins, TJ; Barbas, AS; Worni, M; Mantyh, CR; Migaly, J

Published Date

  • April 2013

Published In

Volume / Issue

  • 17 / 4

Start / End Page

  • 784 - 792

PubMed ID

  • 23242848

Pubmed Central ID

  • 23242848

Electronic International Standard Serial Number (EISSN)

  • 1873-4626

Digital Object Identifier (DOI)

  • 10.1007/s11605-012-2117-x

Language

  • eng

Conference Location

  • United States