Eric Then, MD1, Dustin Uhlenhopp, DO2, Michell Lopez, MD1, Srikanth Maddika, MD1, Tagore Sunkara, MD2, Andrea Culliford, MD, FACG1, Vinaya Gaduputi, MD, FACG1; 1St. Barnabas Hospital, Bronx, NY; 2Mercy Medical Center, Des Moines, IA
Introduction: Ischemic colitis is a gastrointestinal disorder that occurs when the blood supply of the large intestine becomes compromised. End stage renal disease (ESRD) is a known pathology that results in accelerated atherosclerosis, which results in a high mortality alone. The conjunction of these two pathologies has been seldom studied. Our aim was to elucidate the relationship between ESRD and ischemic colitis. Methods: We retrospectively analyzed patients hospitalized with ischemic colitis (via ICD-10 codes) in 2016 using the National Inpatient Sample (NIS) database. Our primary endpoint was to elucidate if the presence of ESRD worsened outcomes in patients with ischemic colitis. We accomplished this by extracting baseline demographic data, and hospital outcomes including length of hospital stay (LOS), total hospital cost, total hospital charge and inpatient mortality. Additionally we looked at rates of colectomy between both groups, which suggested a more severe course of disease. Categorical variables were compared using the chi-square test, and continuous variables were compared using t-test. Multivariate regressions models and all statistical analysis were performed using STATA 15 software. Results: A total of 25, 035 patients hospitalized for ischemic colitis were identified in our study. Of those, 970 carried a secondary diagnosis of ESRD. We found that ischemic colitis patients with ESRD presented at a younger age (65.9 years vs 70.3 years; p-value: < 0.01) than patients who did not have ESRD. Additionally patients with ESRD had a longer LOS (8.5 days vs 4.5 days; p-value: < 0.01), higher hospital charge ($105,870 vs $42,483; p-value: < 0.01) and higher hospital cost ($23,998 vs $10,313; p-value: < 0.01). On multivariate analysis adjusting for age, race, gender and co-morbid conditions (A-fib, CAD, CHF, PVD) we found that patients with ESRD were more likely to die (OR: 2.82; 95% CI: 1.61 – 4.95; p-value: < 0.01) and more likely to undergo colectomy (OR: 2.50; 95% CI: 1.41 – 4.40; p-value: < 0.01) compared to ischemic colitis patients who did not have ESRD. Discussion: We conclude that the presence of ESRD results in worse outcomes in ischemic colitis. This was evidenced by an approximately three times increased risk of mortality, and two times increased length of hospital stay.
Table 1. Baseline demographic characteristics
Table 2. Hospital outcomes
Table 3. Multivariate analysis for in hospital mortality
Disclosures: Eric Then indicated no relevant financial relationships. Dustin Uhlenhopp indicated no relevant financial relationships. Michell Lopez indicated no relevant financial relationships. Srikanth Maddika indicated no relevant financial relationships. Tagore Sunkara indicated no relevant financial relationships. Andrea Culliford indicated no relevant financial relationships. Vinaya Gaduputi indicated no relevant financial relationships.