Department of Internal Medicine, MercyOne Des Moines Medical Center, 1111 6th Avenue, Des Moines, IA, 50314, USA.
Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center - Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, NY, USA.
Int J Colorectal Dis. 2021 Nov;36(11):2455-2461. doi: 10.1007/s00384-021-03935-5. Epub 2021 May 13.
Ischemic colitis (IC) occurs when the blood supply of the large intestine becomes compromised. Several cardiovascular conditions, such as coronary artery disease, congestive heart failure, and atrial fibrillation, are well-established risk factors for the development of IC. The effects of pulmonary conditions, namely chronic obstructive pulmonary disease (COPD), on IC have not been well studied.
Our aim was to elucidate if the presence of COPD worsened outcomes in patients with IC.
Retrospective analysis of patients hospitalized with IC in 2016 was evaluated using the National Inpatient Sample database. Baseline demographic data, length of hospital stay (LOS), total hospital cost/charge, rates of colectomy, and in-hospital mortality were extracted from the database. Categorical variables were compared using the chi-square test and continuous variables were compared using the t-test.
A total of 25,035 patients with IC were identified while 4482 of these patients also had COPD. We found that IC patients with COPD had a longer LOS (5.8 days vs 4.4 days; P<0.01), higher total hospital charge ($56,682 vs $42,365; P<0.01), higher total hospital cost ($13,603 vs $10,238; P<0.01), higher mortality rate (6.5% vs 3.1%; P<0.01), and higher colectomy rate (5.1% vs 3.7%; P<0.01).
The presence of COPD portends poor outcomes in patients with IC. This was evidenced by increased risk of death and increased risk of undergoing colectomy. Given these findings, patients with COPD warrant closer observation. We advocate that COPD be considered as part of the risk assessment of patients with acute IC who need surgical intervention.
缺血性结肠炎是由于大肠的血液供应受到影响而发生的。几种心血管疾病，如冠状动脉疾病、充血性心力衰竭和心房颤动，是缺血性结肠炎发展的公认危险因素。肺部疾病，如慢性阻塞性肺疾病（COPD）对缺血性结肠炎的影响尚未得到很好的研究。
我们旨在阐明 COPD 的存在是否会使缺血性结肠炎患者的预后恶化。
使用国家住院患者样本数据库对 2016 年住院治疗的缺血性结肠炎患者进行回顾性分析。从数据库中提取基线人口统计学数据、住院时间（LOS）、总住院费用/费用、结肠切除术率和住院死亡率。使用卡方检验比较分类变量，使用 t 检验比较连续变量。
共确定了 25035 例缺血性结肠炎患者，其中 4482 例患者同时患有 COPD。我们发现，患有 COPD 的缺血性结肠炎患者的 LOS 更长（5.8 天 vs 4.4 天；P<0.01），总住院费用更高（56682 美元 vs 42365 美元；P<0.01），总住院费用更高（13603 美元 vs 10238 美元；P<0.01），死亡率更高（6.5% vs 3.1%；P<0.01），结肠切除术率更高（5.1% vs 3.7%；P<0.01）。
COPD 的存在预示着缺血性结肠炎患者的预后不良。这表现在死亡风险增加和结肠切除术风险增加。鉴于这些发现，COPD 患者需要密切观察。我们主张将 COPD 视为需要手术干预的急性缺血性结肠炎患者的风险评估的一部分。
