Can we predict the development of ischemic colitis among patients with lower abdominal pain?
OBJECTIVE
This study was performed to find clinical risk factors for developing ischemic colitis in patients experiencing lower abdominal discomfort with or without bloody diarrhea.


METHODS
A total of 467 patients who underwent sigmoidoscopy or colonoscopy because of lower abdominal discomforts with or without blood in stool were consecutively enrolled; 147 patients were diagnosed endoscopically and histologically as having ischemic colitis. The control group was composed of the remaining 320 patients with nonspecific endoscopic/histologic findings. Clinical variables were compared between the ischemic colitis group and the control group.


RESULTS
After excluding 67 patients in the ischemic colitis group, we compared the remaining 80 patients to the control group, using various clinical parameters. According to the logistic regression analysis, six factors were significantly related to ischemic colitis: older than aged 60 years (adjusted odds ratio, 5.7; 95 percent confidence interval: 2.6-11.7), hemodialysis (5; 1.2-21.6), hypertension (4.9; 2.3-10.5), hypoalbuminemia (3.5; 1.8-6.7), diabetes mellitus (3.4; 1.3-8.8), and constipation-inducing medications (2.8; 1.1-7.1). Through our analysis, we were able to predict the development of ischemic colitis for the patients with 0, 1, 2, 3, or 4+ risk factors: 8, 21, 55, 79, and 100 percent, respectively.


CONCLUSIONS
Old age, hemodialysis, hypertension, diabetes mellitus, hypoalbuminemia, and constipation-inducing medications are clinically important risk factors for ischemic colitis in patients experiencing lower abdominal discomfort with or without bloody stool. By considering these factors, we were able to predict with high accuracy the development of ischemic colitis.
Park
Chi Jun
CJ
Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 445 Kildong, Kangdong-Gu, Seoul, South Korea.
Jang
Myoung Kuk
MK
Shin
Woon Geon
WG
Kim
Hyoung Su
HS
Kim
Hee Seon
HS
Lee
Ki Sung
KS
Lee
Ja Young
JY
Kim
Kyung Ho
KH
Park
Joon Yong
JY
Lee
Jin Heon
JH
Kim
Hak Yang
HY
Nam
Eun Sook
ES
Yoo
Jae Young
JY
D015746:Abdominal Pain / Q000209:etiology*; D016009:Chi-Square Distribution; D017091:Colitis, Ischemic / Q000150:complications / Q000175:diagnosis*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012812:Sigmoidoscopy
D012709:Serum Albumin