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Chronic obstructive pulmonary disease is associated with worse outcomes in ischemic colitis: a nationwide retrospective study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

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.

Aims

Our aim was to elucidate if the presence of COPD worsened outcomes in patients with IC.

Methods

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.

Results

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).

Conclusions

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.

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Acknowledgements

The authors would like to recognize the contributions of The Healthcare Cost and Utilization Project staff who collected the data used in this study.

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Authors and Affiliations

  1. Department of Internal Medicine, MercyOne Des Moines Medical Center, 1111 6th Avenue, Des Moines, IA, 50314, USA

    Dustin J Uhlenhopp

  2. Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center – Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, NY, USA

    Eric Then, Mohamed Barakat & Febin John

  3. Department of Internal Medicine, Interfaith Medical Center, Brooklyn, NY, USA

    Vijay Gayam

  4. Department of Gastroenterology and Hepatology, MercyOne Des Moines Medical Center, Des Moines, IA, USA

    Tagore Sunkara & Vinaya Gaduputi

Authors
  1. Dustin J Uhlenhopp
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  2. Eric Then
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  3. Mohamed Barakat
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  4. Febin John
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  5. Vijay Gayam
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Corresponding author

Correspondence to Dustin J Uhlenhopp.

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Human and animal rights

No animals were used in this research. All procedures performed in studies involving human participants were in accordance with the ethical standards of institutional and/or research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent for publication

This study contained de-identified information from a national database. The Healthcare Cost and Utilization Project (HCUP) databases are consistent with the definition of limited data sets under the HIPAA Privacy Rule and contain no direct patient identifiers. HCUP Data Use Agreement (DUA) training and a signed DUA are required to use the HCUP databases. As such, individual participant consent is not required. For this type of retrospective database study, formal consent is not required. Institutional Review Board approval is not required for this study.

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The authors declare no competing interests.

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This work was presented as an abstract at the American College of Gastroenterology Annual Scientific Meeting on October 23, 2020 online.

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Uhlenhopp, D.J., Then, E., Barakat, M. et al. Chronic obstructive pulmonary disease is associated with worse outcomes in ischemic colitis: a nationwide retrospective study. Int J Colorectal Dis 36, 2455–2461 (2021). https://doi.org/10.1007/s00384-021-03935-5

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  • DOI: https://doi.org/10.1007/s00384-021-03935-5

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