Eric Then, MD1, Dustin Uhlenhopp, DO2, Michell Lopez, 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. Cardiovascular conditions such as congestive heart failure (CHF) and Atrial Fibrillation are well-established risk factors for the development of ischemic colitis. The effect of pulmonary conditions, namely, chronic obstructive pulmonary disease on ischemic colitis however is not well studied. Our aim was to establish a link between these two pathologies. 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 COPD 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 with Ischemic Colitis were identified in our study. Of these, 4,482 patients had a secondary diagnosis of COPD. We found that IC patients with COPD had a longer LOS (5.8 days vs 4.4 days; p-value: < 0.01), higher total hospital charges ($56,682 vs 42,365; p-value: < 0.01), higher total hospital cost ($13,603 vs $10,238; p-value < 0.01), higher mortality rate (6.5% vs 3.1%; p-value: < 0.01) and higher colectomy rate (5.1% vs 3.7%; p-value < 0.01). Additionally on multivariate analysis, when adjusting for age, race, gender and co-morbid conditions (A-fib, CAD, CHF, PVD) we found that COPD patients were more likely to die (OR: 2.05; 95% CI: 1.46 – 2.89; p-value: < 0.01) and more likely to undergo colectomy (OR: 1.44; 95% CI: 1.01 – 2.06; p-value: 0.04) when compared to patients who did not have COPD. Discussion: We found that the presence of COPD portends poorer outcomes in patients with ischemic colitis. This was evidenced by an increased risk of death, and increased risk of undergoing colectomy. These findings should promote more robust public health measures for tobacco cessation, to ultimately reduce mortality from ischemic colitis and COPD alike.
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. Tagore Sunkara indicated no relevant financial relationships. Andrea Culliford indicated no relevant financial relationships. Vinaya Gaduputi indicated no relevant financial relationships.