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Journal of Gastrointestinal Surgery

, Volume 17, Issue 4, pp 784–792 | Cite as

A 10-Year Longitudinal Analysis of Surgical Management for Acute Ischemic Colitis

  • Anthony W. CastleberryEmail author
  • Ryan S. Turley
  • Jennifer M. Hanna
  • Thomas J. Hopkins
  • Andrew S. Barbas
  • Mathias Worni
  • Christopher R. Mantyh
  • John Migaly
Original Article

Abstract

Introduction

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.

Conclusion

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.

Keywords

Ischemic colitis Colonic diseases/surgery Postoperative period Postoperative complications Outcomes assessment 

Notes

Financial disclosure/funding support

The authors have no potential conflicts of interest, including specific financial interests, relationships, and affiliations relevant to the subject matter or materials discussed in the manuscript.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Anthony W. Castleberry
    • 1
    Email author
  • Ryan S. Turley
    • 1
  • Jennifer M. Hanna
    • 1
  • Thomas J. Hopkins
    • 2
  • Andrew S. Barbas
    • 1
  • Mathias Worni
    • 1
    • 3
  • Christopher R. Mantyh
    • 1
    • 4
  • John Migaly
    • 1
    • 4
  1. 1.Department of General SurgeryDuke University Medical CenterDurhamUSA
  2. 2.Department of AnesthesiaDuke University Medical CenterDurhamUSA
  3. 3.Department of Visceral Surgery and Medicine, InselspitalUniversity of BerneBerneSwitzerland
  4. 4.Section of Colon & Rectal SurgeryDuke University Medical CenterDurhamUSA

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