Format

Send to

Choose Destination
See comment in PubMed Commons below
Clin Gastroenterol Hepatol. 2015 Apr;13(4):731-8.e1-6; quiz e41. doi: 10.1016/j.cgh.2014.07.061. Epub 2014 Aug 12.

A population-based study of incidence, risk factors, clinical spectrum, and outcomes of ischemic colitis.

Author information

1
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
2
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
3
Division of Epidemiology, Mayo Clinic, Rochester, Minnesota.
4
Division of Gastroenterology, University of California, San Diego, La Jolla, California.
5
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. Electronic address: loftus.edward@mayo.edu.

Abstract

BACKGROUND & AIMS:

Little is known about progression of ischemic colitis (IC) among unselected patients. We aimed to estimate the incidence, risk factors, and natural history of IC in a population-based cohort in Olmsted County, Minnesota.

METHODS:

We performed a retrospective population-based cohort and nested case-control study of IC. Each IC case was matched to 2 controls from the same population on the basis of sex, age, and closest registration number. Conditional logistic regression, the Kaplan-Meier method, and proportional hazards regression were used to assess comorbidities, estimate survival, and identify characteristics associated with survival, respectively.

RESULTS:

Four hundred forty-five county residents (median age, 71.6 years; 67% female) were diagnosed with IC from 1976 through 2009 and were matched with 890 controls. The age-adjusted and sex-adjusted incidence rates of IC nearly quadrupled from 6.1 cases/100,000 person-years in 1976-1980 to 22.9/100,000 in 2005-2009. The odds for IC were significantly higher among subjects with atherosclerotic diseases; odds ratios ranged from 2.6 for individuals with coronary disease to 7.9 for individuals with peripheral vascular disease. Of IC cases, 59% survived for 5 years (95% confidence interval, 54%-64%), compared with 90% of controls (95% confidence interval, 88%-92%). Age >40 years, male sex, right-sided colon involvement, concomitant small bowel involvement, and chronic obstructive pulmonary disease were all independently associated with mortality (P < .05).

CONCLUSIONS:

The incidence of IC increased during the past 3 decades in a population-based cohort in Minnesota. IC typically presents in older patients with multiple comorbidities and is associated with high in-hospital mortality (11.5%) and rates of surgery (17%).

KEYWORDS:

COPD; Cardiovascular Disease; Epidemiologic Study; Intestinal Vasculature

PMID:
25130936
PMCID:
PMC4326614
DOI:
10.1016/j.cgh.2014.07.061
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center