Domestic literature survey on the epidemiology and clinical features of ischemic colitis

Abstract

Objective To investigate the incidence trends, clinical features and prognosis of ischemic colitis (IC) in China, and improve the level of diagnosis and treatment of IC. Methods China National Knowledge Infrastructure and VIP Chinese Science and Technology Periodical Database were searched. The ending date of search was May 15, 2014. Results A total of 324 references were found, which were published from 1982 to 2013. There were 9202 cases reported, 3973 cases of males and 5229 cases of females, with the male/female ratio of 1∶1.32 and mean age of (63.6±7.8) years. The amount of references and cases reported began to rise after 2002. Estimated ratio of cumulative incidence was higher in the north than in other areas of China (χ2=1097.95, P=0.000). The most common IC-accompanying diseases were hypertension, heart diseases, diabetes, hyperlipidemia and constipation. There were statistically significant differences in the accompanying diseases between different regions and different times. Drugs, enteroscopy, surgery and low blood volume might be the precipitating factors. Patients commonly complained of abdominal pain, diarrhea/desiring to defecate and hematochezia. Computed tomography was feasible in detecting lesions. Colonoscopy was the main method for diagnosis. The lesions were most common located in the left half colon including sigmoid colon, descending colon and splenic flexure, with typically in a segmental manner. Pan-colon involvement or rectum involvement rarely occurred. Type of transient lesion was the predominant subtype, which was generally managed non-operatively with good prognosis. Different from the type of transient lesion, pathological changes in gangrenous type were located in the right half colon including hepatic flexure of transverse colon, ascending colon and ileocecal junction. Gangrenous type required prompt surgical intervention but the mortality was much higher. Conclusions Incidence of CI has been increasing year by year. Patients who complain of abdominal pain, diarrhea/desiring to defecate and hematochezia should be considered as IC, particularly in the elderly women and patients with cardiovascular disease. Diseased regions are mainly located in sigmoid colon, descending colon and splenic flexure. Transient colitis is the predominant subtype, which have good prognosis. Key words: Colitis, ischemic; Data interpretation, statistical