4474 Prognostics factors of death in ischemic colitis.

BACKGROUND & AIMS: Ischemic colitis (IC) is considered a disease of elderly patients who have associated diseases. The aim of this study was to evaluate the mortality prognostic factors in patients with IC. PATIENTS AND METHODS: Analysis of 66 consecutive patients (30 men and 36 women) with this disease. We evaluated clinical, analytic, endoscopic, histologic and evolutionary data. Odds Ratio (OR) and the χ 2 test were used. RESULTS: The patients age ranged from 49 to 94 years (mean : 73 years). Mean hospitalization was 15±12 days. Patients presented mainly with hematochezia (97 %) and abdominal pain (74 %). Co-morbility were present in 56 of 66 patients (85 %). Fourteen of 66 patients (22 %) were found to have more than two segments affected. The majority of lesions occured in the sigmoid colon (89 % cases). The severity endoscopic features ( Ann. Gastroenterol. Hepatol., 1990, 26 : 181-183 ) was grade I (29 %), grade II (63 %) and grade III (8 %). Ten of 66 patients (15 %) presented colonic strictures. Five of 66 patients (8 %) required surgery. Seven patients (11 %) died. The death was significantly associated with LDH>600U/l (OR=26,2; IC=2,9-240), >2 segments of colon affected (OR=37,5; IC=3,8-353,9) and subocclusion (OR=23,2; IC=1,8-302,7). Normal LDH was associated with favourable evolution (OR=0,04; IC=0-0,35). CONCLUSIONS: Increased LDH (>600U/l), extension of colitis and subocclusion were significant prognostics factors of death.