Older patients are significantly more likely to have colon ischaemia-associated conditions that are chronic and complex.

Abstract

Colon ischaemia is a common disease which has been associated with various medications and comorbidities. To test the hypothesis that there are differences in the frequencies of these associations in older compared with younger patients. A retrospective cohort study was performed of patients hospitalized with colon ischaemia at two major medical centres from 2005-2017. Clinical, colonoscopic and pathologic criteria were used to identify patients admitted with colon ischaemia; patients with other types of colitis were excluded. Demographic and medical data were extracted. Two cohorts were created: patients aged 18-64years and patients>65years. These were compared using SAS 14.3. A total of 788 patients were included, of which 271 (34.4%) were of ages 18-64years, and 517 (66.6%) were 65years old or older. In the older cohort, constipation-inducing medications (83.8% vs 64.1%; P=<0.0001), diuretics (38.1% vs 25.1%; P=<0.001) and nonsteroidal anti-inflammatory drugs (58% vs 41.5%; P=<0.0001) were more common than in the younger cohort. Antipsychotic medication use was more common in the younger cohort (10.4% vs 5.4%; P=0.01). There was a higher percentage of younger patients with a history of hypercoaguable state (1.9% vs 0.2%; P=0.03) and dialysis dependence (22.9% vs 8.7%; P=<0.01), while a higher percentage of patients in the older cohort had a history of chronic obstructive pulmonary disease (12% vs 6.3%; P=0.01) or atrial fibrillation (18.9% vs 10.3%; P=<0.01). Our study shows that older patients are more likely to have colon ischaemia-associated conditions that are chronic and complex, while younger patients are more likely to have acute colon ischaemia-associated conditions.