title: The predictors of the severity of ischaemic colitis: a systematic review of 2823 patients from 22 studies.
abstract: OBJECTIVE
  The study reviews the literature related to ischaemic colitis (IC) as the evidence base to identify factors predicting severity.
  
  
  METHODS
  A systematic review of the literature was conducted on the predictors of the severity of IC. Severe IC or adverse outcome of IC was defined as a patient requiring surgery or who died. MEDLINE, Embase and Cochrane Library databases were searched from inception to 15 January 2015. Manual searches of reference lists from potentially relevant papers and meetings were also performed.
  
  
  RESULTS
  In all, 22 studies involving 2823 patients were identified; 19 were case series, two were case-control studies and one was a cohort study. The overall adverse outcome rate was 22.0% (620/2823). The prognostic predictors for surgery or mortality which were most frequently reported included right sided IC, peritonitis, shock or arterial hypotension (< 90 mmHg), male gender, tachycardia and lack of rectal bleeding. Thirteen studies relating to the right colon from which data could be extracted were further analysed. The right colon was involved in 277 cases, with an incidence of adverse outcomes of 48.4% (134/277), while in the non-right colonic involvement group the incidence was significantly lower at 12.1% (142/1175) (P = 0.000).
  
  
  CONCLUSIONS
  The incidence of adverse outcome in patients with IC remains high. Male gender, tachycardia, lack of rectal bleeding, peritonitis, shock or arterial hypotension (< 90 mmHg) and right sided IC are predictors of poor prognosis. Right-sided IC, shock or arterial hypotension (< 90 mmHg) and signs of peritonitis may be the most significant predictors of severity.
authors.affiliation: Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: D
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Gastroenterology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
authors.forename: L
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Gastroenterology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
authors.forename: M
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China. cfy429@163.com.
authors.forename: F
authors.initials: F
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017091:Colitis, Ischemic / Q000150:complications / Q000473:pathology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology; D011379:Prognosis; D012720:Severity of Illness Index; D012737:Sex Factors; D013610:Tachycardia / Q000209:etiology
keywords: Ischaemic colitis; prognostic factors; systematic review