Resident Creighton University Arizona Health Education Alliance Phoenix, Arizona
Ishani Shah, MD1, Harsh Mehta, MD2, Kambiz Kadkhodayan, MD1; 1Creighton University Arizona Health Education Alliance, Phoenix, AZ; 2Saint Barnabas Medical Center, West Orange, NJ
Introduction: Ischemic colitis (IC) is a serious condition that can often be associated with thromboembolism due to atrial fibrillation (AF). It has high morbidity and mortality, with around 15% of the patients developing bowel gangrene. About one-third of patients with thromboembolic IC are known to have a cardiac source. The aim of this study is to compare demographic, interventional, and patient-outcome data among IC patients with and without AF. Methods: Using the Nationwide Inpatient Sample (NIS), all adults with IC during the year 2016 were identified. They were divided into two groups - those with AF and those without AF. Primary outcomes were inpatient mortality, length of stay and cost of hospitalization. Secondary outcomes were complications and interventions required during hospitalization. Descriptive analyses were compared using the t-test for continuous data and chi-square test for categorical data. Statistical significance was assigned at P< 0.05. Results: A total of 933 patients were hospitalized with a primary diagnosis of IC in 2016, out of which 17.47% patients had AF. Rate of complications such as AKI (47.24% vs 34.29%; p=0.001), sepsis (39.25% vs 23.12%; p< 0.001), septic shock (28.22% vs 16.75%; p< 0.001) and respiratory failure (34.97% vs 17.92%; p< 0.001) was higher in AF patients, as was the rate of colonic resection (25.77% vs 18.77%; p=0.03) (Figure 1). Overall mortality (22.22% vs 13.84%; p=0.008), length of stay (11.43 vs 8.56 days; p=0.001) and total charges of hospitalization ($218,538 vs $123,611; p=0.004) were all higher among patients with AF (table 1). Other demographic characteristics of patients in both groups are outlined in table 2. Discussion: Our study showed that patients with AF-associated IC had higher morbidity and mortality. These patients also contributed to adverse utilization of health-care resources as evidenced by longer hospital stays and higher cost of hospitalization.Increased adoption of guidelines with regards to anticoagulation in patients with AF will hopefully lead to a reduction in the rate of IC-hospitalizations.
Complications, outcomes and interventions among IC patients with and without AF
Demographic characteristics of patients hospitalized with ischemic colitis with and without atrial fibrillation
Disclosures: Ishani Shah indicated no relevant financial relationships. Harsh Mehta indicated no relevant financial relationships. Kambiz Kadkhodayan indicated no relevant financial relationships.