title: A 10-year longitudinal analysis of surgical management for acute ischemic colitis.
abstract: BACKGROUND
  Our objective was to review our 10-year experience of surgical resection for acute ischemic colitis (IC) and to assess the predictive value of previously reported risk-stratification methods.
  
  
  METHODS
  We retrospectively reviewed all adult patients at our institution undergoing colectomy for acute IC between 2000 and 2009. Descriptive statistics were calculated. Long-term survival was assessed using Kaplan-Meier methods and in-hospital mortality using multivariate logistic regression. Patients were risk-stratified based on previously reported methods, and discriminatory accuracy of predicting in-hospital mortality was evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.
  
  
  RESULTS
  A total of 115 patients were included for analysis, of which 37 % (n = 43) died in-hospital. The median survival was 4.9 months for all patients and 43.6 months for patients surviving to discharge. Seventeen patients subsequently underwent end-ostomy reversal at our institution, with in-hospital mortality of 18 % (n = 3) and ICU admission for 35 % (n = 6). The discriminatory accuracy of risk stratification in predicting in-hospital mortality based on ROC AUC was 0.75.
  
  
  CONCLUSIONS
  Acute IC continues to remain a very deadly disease. Patients who survive the initial acute IC insult can achieve long-term survival; however, we experienced high rates of death and complications following elective end-ostomy reversal. Risk stratification provides reasonable accuracy in predicting postoperative mortality.
authors.affiliation: Department of General Surgery, Duke University Medical Center, Box 3443, Durham, NC 27710, USA. anthony.castleberry@duke.edu
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Castleberry
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Turley
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Hanna
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Hopkins
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Barbas
authors.forename: Mathias
authors.initials: M
authors.lastname: Worni
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Mantyh
authors.forename: John
authors.initials: J
authors.lastname: Migaly
mesh_terms: D000208:Acute Disease; D003082:Colectomy; D017091:Colitis, Ischemic / Q000601:surgery*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013997:Time Factors