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Congestive Heart Failure Is Associated With Worse Outcomes in Patients With Ischemic Colitis: A Nationwide Study
Ratib Mahfouz1, Landon A Kozai2, Adham E Obeidat3
1Internal Medicine, Kent Hospital/Brown University, Warwick, USA.
Insights
Congestive heart failure (CHF) significantly worsens outcomes for patients with ischemic colitis (IC). Patients with both conditions experienced higher mortality and colectomy rates compared to those with IC alone.
Area of Science:
- Gastroenterology
- Cardiology
- Health Services Research
Background:
- Ischemic colitis (IC) arises from reduced blood flow to the colon.
- Key risk factors include atrial fibrillation (A.Fib), peripheral artery disease (PAD), coronary artery disease (CAD), and congestive heart failure (CHF).
- Limited research exists comparing mortality and colectomy rates between IC patients with and without CHF.
Purpose of the Study:
- To evaluate if patients with IC and CHF have poorer outcomes than those with IC alone.
Main Methods:
- Utilized the National Inpatient Sample database (2016-2019).
- Analyzed demographic data, hospital charges, colectomy rates, length of stay (LOS), and in-hospital mortality.
- Compared data using t-tests and chi-squared analyses; calculated odds ratios for comorbidities.
Main Results:
- Identified 106,705 IC patients, with 15,220 also having CHF.
- IC patients with CHF had longer LOS (6.6 vs 4.4 days), higher hospital charges ($71,359 vs $45,176), increased mortality (8.5% vs 2.9%), and higher colectomy rates (9.2% vs 5.9%).
- All comparisons were statistically significant (P<0.0001).
Conclusions:
- Congestive heart failure (CHF) is linked to adverse outcomes in ischemic colitis (IC) patients.
- The study demonstrates an elevated risk of mortality and colectomy in IC patients with CHF.
- Heightened clinical suspicion for IC is recommended in CHF patients presenting with rectal bleeding.
Introduction:
Ischemic colitis (IC) results from compromised blood flow to the colon. Risk factors include atrial fibrillation (A.Fib), peripheral artery disease (PAD), coronary artery disease (CAD), and congestive heart failure (CHF). However, few studies compared the mortality rate and colectomy between patients with IC with CHF and IC alone.
Objective:
We aim to investigate the possibility of worse outcomes in patients with IC and CHF compared to IC alone.
Methodology:
Using the National Inpatient Sample database from 2016 to 2019, we obtained baseline demographic data, total hospital charge, rate of colectomy, length of hospital stay (LOS), and in-hospital mortality. Data were compared using a t-test and chi-squared. Odds ratios for comorbidities including A.Fib, CAD, PAD, end-stage renal disease, chronic obstructive pulmonary disease, hyperlipidemia, hypertension, diabetes, and cirrhosis were calculated.
Results:
106,705 patients with IC were identified, among which 15,220 patients also had CHF. IC patients with CHF had a longer LOS (6.6 days vs 4.4 days; P<0.0001), higher total hospital charge ($71,359 vs $45,176; P<0.0001), higher mortality rate (8.5% vs 2.9%; P<0.0001), and higher colectomy rate (9.2% vs 5.9%; P<0.0001).
Conclusion:
CHF is associated with poor outcomes in patients with IC. Our study showed an increased risk of mortality and colectomy compared to patients with IC alone. The findings suggest it may be warranted to have a heightened clinical suspicion of IC in patients with CHF who present with bleeding per rectum.
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