Related Experiment Video
Updated: Nov 21, 2025
Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice
Published on: July 12, 2018
Cirrhosis Is Associated With Worse Outcomes in Ischemic Colitis: A Nationwide Retrospective Study
Eric Then1, Caitlin Lund2, Dustin J Uhlenhopp3
1Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center - Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, NY, USA.
Insights
Cirrhosis significantly increases mortality risk in patients with ischemic colitis (IC), despite not raising colectomy rates. Patients with cirrhosis require closer monitoring due to their compromised state.
Area of Science:
- Gastroenterology
- Hepatology
- Vascular Surgery
Background:
- Ischemic colitis (IC) results from compromised blood flow to the large intestine.
- Cirrhosis creates a complex pro-coagulant and anti-coagulant balance.
- The study investigates how cirrhosis affects outcomes in patients diagnosed with IC.
Purpose of the Study:
- To determine the impact of cirrhosis on patient outcomes following ischemic colitis.
- To compare mortality rates, colectomy rates, length of stay, and hospital charges between IC patients with and without cirrhosis.
Main Methods:
- Retrospective analysis of the National Inpatient Sample database for patients hospitalized with IC in 2017.
- Extracted demographic data, length of stay (LOS), total hospital charge, colectomy rates, and in-hospital mortality.
- Compared categorical variables using Chi-square test and continuous variables using t-test.
Main Results:
- A total of 29,035 IC patients were identified; 420 had cirrhosis.
- IC patients with cirrhosis were younger, more likely male, Black, and Hispanic.
- Patients with cirrhosis experienced longer LOS, higher hospital charges, and significantly higher in-hospital mortality (10.7% vs. 3.6%).
Conclusions:
- Cirrhosis is linked to increased in-hospital mortality in ischemic colitis patients.
- This may reflect a reduced physiological reserve in patients with cirrhosis to tolerate ischemic events.
- While colectomy rates were not increased, closer observation of IC patients with cirrhosis is warranted.
Background:
Ischemic colitis (IC) occurs when the blood supply of the large intestine becomes compromised. Cirrhosis is a disease entity in which there is a delicate balance between pro-coagulant and anti-coagulant states. Our aim was to examine the impact cirrhosis has on outcomes in patients with ischemic colitis.
Methods:
A retrospective analysis of patients hospitalized with IC in 2017 was evaluated using the National Inpatient Sample database. Baseline demographic data, length of hospital stay (LOS), total hospital charge, rates of colectomy and in-hospital mortality were extracted from the database. Categorical variables were compared using the Chi-square test and continuous variables were compared using t-test.
Results:
A total of 29,035 patients with IC were identified, while 420 of these patients also had cirrhosis. Patients with IC and cirrhosis were noted to be younger age at presentation when compared to patients with IC and no cirrhosis (mean 63.9 years vs. 70.4 years; P < 0.001). When comparing both groups, IC patients with cirrhosis were more likely to be male (50% vs. 26.1%; P < 0.001), Black (10.9% vs. 7.6%; P = 0.013) and Hispanic (18% vs. 6.1%; P < 0.001). We found that IC patients with cirrhosis had a longer LOS (7.3 days vs. 4.8 days; P < 0.001), higher total hospital charge ($84,769 vs. $48,347; P < 0.001) and higher mortality rate (10.7% vs. 3.6%; P < 0.001); however, the presence of cirrhosis was not associated with increased odds of undergoing colectomy (odds ratio: 0.31; 95% confidence interval: 0.07 - 1.27; P = 0.104).
Conclusions:
The presence of cirrhosis is associated with increased odds of in-hospital mortality in those presenting with IC. This compounds the already high rates of mortality in patients that undergo surgery for IC and could reflect lack of reserve to withstand the ischemic episode in the setting of cirrhosis. Though odds of undergoing colectomy is not increased, patients with cirrhosis warrant closer observation.
Related Concept Videos
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:17Gastritis-II: Pathophysiology
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...