Different Treatment and Outcome Between In-hospital and Out-hospital Patients with Acute Ischemic Colitis

Abstract

Purpose: Acute ischemic colitis (IC) is a life-threatening abdominal disease that requires early diagnosis and therapy to prevent bowel necrosis and ultimately patient's death. It is unknown whether the patient's status and background with regard to prior hospitalization may have an impact on the therapeutic management and clinical course. Aim of this study was to examine whether the patient's background may influence the surgical treatment and outcome of patients with IC. Methods: All patients with IC who received surgical treatment at our institution from January 2002 to January 2008 were prospectively included in a database. For further analysis, we subdivided all patients into the two groups “in-hospital patients” (G1) and “out-hospital patients” (G2). Results: Of the 177 patients (113 men, 64 women) with IC, 121 were assigned to G1 and 56 to G2. Low cardiac output was the predominant cause for development of IC in G1 (64.5% in G1 vs. 23.2% in G2) while occlusion of the mesenteric artery (32.1% in G1 vs. 15.7% in G2) was more prevalent in G2. Surgical therapy consisted of subtotal colectomy (predominantly performed in G1) and right or left hemicolectomy (mainly performed in G2). Overall morbidity and mortality (52.1% vs. 39.3%; p = 0.1) was increased in the in-hospital patient group, though this difference was not statistically significant. Conclusion: The present study for the first time indicated that the hospital status of patients diagnosed with IC substantially influences surgical treatment and clinical outcome. These observations might help to facilitate adequate clinical management and surgical therapy of patients with IC.