title: Mortality, recurrence, and hospital course of patients with systemic sclerosis-related acute intestinal pseudo-obstruction.
abstract: OBJECTIVE
  Acute intestinal pseudo-obstruction is a rare gastrointestinal manifestation of systemic sclerosis (SSc) with few data existing as to its demographics, clinical course, outcomes, and mortality.
  
  
  METHODS
  We undertook a case-control study to describe 64 cases in 37 unique patients, of whom 70% had spontaneous resolution with conservative measures of intravenous hydration and bowel rest, 9% underwent surgical resection, and 25% required prolonged total parenteral nutrition (TPN).
  
  
  RESULTS
  Hospital course was for a mean of 12 ± 12.5 days and there was a 16% patient mortality in our population. In a subgroup analysis, patients who had recurrent episodes of pseudo-obstruction were less likely to have esophageal involvement from SSc, and more likely to need prolonged TPN. Mortality tended to be higher in male patients and patients who did not have SSc-related esophageal involvement, and also in patients who had low hemoglobin and serum albumin at presentation. The need for a nasogastric tube for decompression and a surgical intervention correlated with a more prolonged hospital stay.
  
  
  CONCLUSIONS
  To the best of our knowledge, ours is the largest study looking at this rare manifestation of SSc.
authors.affiliation: From the Division of Rheumatology, University of Pennsylvania; the Division of Rheumatology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.C. Mecoli, MD, Resident in Medicine; C.T. Derk, MD, Associate Professor of Medicine, Division of Rheumatology, University of Pennsylvania; S. Purohit, MD, Fellow in Medicine; N. Sandorfi, MD, Associate Professor of Medicine, Division of Rheumatology, Thomas Jefferson University.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mecoli
authors.affiliation: From the Division of Rheumatology, University of Pennsylvania; the Division of Rheumatology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.C. Mecoli, MD, Resident in Medicine; C.T. Derk, MD, Associate Professor of Medicine, Division of Rheumatology, University of Pennsylvania; S. Purohit, MD, Fellow in Medicine; N. Sandorfi, MD, Associate Professor of Medicine, Division of Rheumatology, Thomas Jefferson University.
authors.forename: Shivani
authors.initials: S
authors.lastname: Purohit
authors.affiliation: From the Division of Rheumatology, University of Pennsylvania; the Division of Rheumatology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.C. Mecoli, MD, Resident in Medicine; C.T. Derk, MD, Associate Professor of Medicine, Division of Rheumatology, University of Pennsylvania; S. Purohit, MD, Fellow in Medicine; N. Sandorfi, MD, Associate Professor of Medicine, Division of Rheumatology, Thomas Jefferson University.
authors.forename: Nora
authors.initials: N
authors.lastname: Sandorfi
authors.affiliation: From the Division of Rheumatology, University of Pennsylvania; the Division of Rheumatology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.C. Mecoli, MD, Resident in Medicine; C.T. Derk, MD, Associate Professor of Medicine, Division of Rheumatology, University of Pennsylvania; S. Purohit, MD, Fellow in Medicine; N. Sandorfi, MD, Associate Professor of Medicine, Division of Rheumatology, Thomas Jefferson University. Chris.Derk@uphs.upenn.edu.
authors.forename: Chris T
authors.initials: CT
authors.lastname: Derk
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D012008:Recurrence; D012595:Scleroderma, Systemic / Q000150:complications*; D016896:Treatment Outcome
keywords: CLINICAL; GASTROINTESTINAL; INTESTINAL; OBSTRUCTION; SCLERODERMA; SYSTEMIC SCLEROSIS