title: Ischemic colitis as a cause of severe hematochezia: risk factors and outcomes compared with other colon diagnoses.
abstract: BACKGROUND
  Risk factors and outcomes of severe hematochezia from ischemic colitis compared with other colonic diagnoses have not been well studied.
  
  
  OBJECTIVE
  Our purposes were (1) to compare demographics and outcomes of patients hospitalized with severe hematochezia from ischemic colitis compared with other colonic diagnoses, (2) to compare inpatient and outpatient start of bleeding from ischemic colitis, and (3) to describe potential risk factors.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Tertiary referral academic centers.
  
  
  METHODS
  Patients referred for gastroenterology consultation for severe hematochezia.
  
  
  METHODS
  Colonoscopic therapy was provided as indicated.
  
  
  METHODS
  Rebleeding, surgery, and length of hospital stay after colonoscopy.
  
  
  RESULTS
  Of 550 patients in the past 12 years with severe hematochezia from colonic sources, the cause in 65 patients (11.8%) was ischemia. Ischemic colitis was found more often in females, in patients taking anticoagulant agents, in patients with severe lung disease, those with higher creatinine levels, those with higher glucose levels, and those with more fresh frozen plasma transfusions. Five patients with focal lesions had colonoscopic hemostasis. Major 30-day outcomes of ischemic colitis patients were significantly worse than patients with other colonic diagnoses. Patients with inpatient (vs outpatient) ischemic colitis had significantly more and more severe comorbidities at baseline and significantly higher rates of rebleeding, surgery, and more days spent in hospital and in the intensive care unit.
  
  
  CONCLUSIONS
  Two-center study.
  
  
  CONCLUSIONS
  Major 30-day outcomes in ischemic colitis patients were significantly worse than in patients with other colonic diagnoses. Comparing outpatient and inpatient start of ischemic colitis, inpatients had significantly worse outcomes.
authors.affiliation: Center for Ulcer Research and Education, Los Angeles, CA, USA.
authors.forename: Disaya
authors.initials: D
authors.lastname: Chavalitdhamrong
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Jensen
authors.forename: Thomas O G
authors.initials: TO
authors.lastname: Kovacs
authors.forename: Rome
authors.initials: R
authors.lastname: Jutabha
authors.forename: Gareth
authors.initials: G
authors.lastname: Dulai
authors.forename: Gordon
authors.initials: G
authors.lastname: Ohning
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Machicado
mesh_terms: D017091:Colitis, Ischemic / Q000150:complications* / Q000175:diagnosis; D003108:Colonic Diseases / Q000150:complications* / Q000175:diagnosis; D003113:Colonoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors