[Ischemic colitic in the elderly: predictive factors of gangrenous outcome].
OBJECTIVE
To better characterize the presentation of gangrenous and non-gangrenous ischemic colitis in subjects older than 60 years, and to identify risk factors of gangrenous outcome.


METHODS
Retrospective analysis of 80 cases of ischemic colitis (22 male, 58 female; mean age 76.9 +/- 8.7 years) with 64 and 16 non gangrenous and gangrenous forms, respectively.


RESULTS
Hematochezia and diarrhea were significantly less prevalent in gangrenous colitis compared to the non-gangrenous group (31.2% vs 81.2%, P < 0.0001 and 6.2% vs 53.1%, P < 0.0001, respectively), whereas nausea and vomiting, and hyperleukcocytosis were significantly more frequent in the former group (50.0% vs 18.7%, P < 0.01 and 93.7% vs 62.5%, P < 0.02 respectively). Hypertension (P < 0.03), angina (P < 0.05), history of cancer (P < 0.03) and age older than 90 (P < 0.002) were risk factors for gangrenous outcome. After multivariate analysis, only two independent factors were identified, i.e.: hypertension and history of cancer. These factors predicted gangrenous course in 85% of cases.


CONCLUSIONS
Patients older than 60 years suffering from ischemic colitis are at high risk of gangrenous course if they have hypertension or history of cancer.
Barouk
J
J
Service d'Hépato-Gastroentérologie, Hôtel-Dieu, CHU, Nantes.
Gournay
J
J
Bernard
P
P
Masliah
C
C
Le Neel
J C
JC
Galmiche
J P
JP
D000368:Aged; D000369:Aged, 80 and over; D017091:Colitis, Ischemic / Q000150:complications / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005734:Gangrene / Q000209:etiology / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
Colite ischémique du sujet âgé: facteurs prédictifs de l'évolution gangreneuse.