Older patients are significantly more likely to have colon ischaemia-associated conditions that are chronic and complex.


Journal

Alimentary pharmacology & therapeutics
ISSN: 1365-2036
Titre abrégé: Aliment Pharmacol Ther
Pays: England
ID NLM: 8707234

Informations de publication

Date de publication:
06 2019
Historique:
received: 17 01 2019
revised: 12 02 2019
accepted: 27 03 2019
pubmed: 26 4 2019
medline: 15 4 2020
entrez: 26 4 2019
Statut: ppublish

Résumé

Colon ischaemia is a common disease which has been associated with various medications and comorbidities. To test the hypothesis that there are differences in the frequencies of these associations in older compared with younger patients. A retrospective cohort study was performed of patients hospitalized with colon ischaemia at two major medical centres from 2005-2017. Clinical, colonoscopic and pathologic criteria were used to identify patients admitted with colon ischaemia; patients with other types of colitis were excluded. Demographic and medical data were extracted. Two cohorts were created: patients aged 18-64 years and patients > 65 years. These were compared using SAS 14.3. A total of 788 patients were included, of which 271 (34.4%) were of ages 18-64 years, and 517 (66.6%) were 65 years old or older. In the older cohort, constipation-inducing medications (83.8% vs 64.1%; P = <0.0001), diuretics (38.1% vs 25.1%; P = <0.001) and nonsteroidal anti-inflammatory drugs (58% vs 41.5%; P = <0.0001) were more common than in the younger cohort. Antipsychotic medication use was more common in the younger cohort (10.4% vs 5.4%; P = 0.01). There was a higher percentage of younger patients with a history of hypercoaguable state (1.9% vs 0.2%; P = 0.03) and dialysis dependence (22.9% vs 8.7%; P = <0.01), while a higher percentage of patients in the older cohort had a history of chronic obstructive pulmonary disease (12% vs 6.3%; P = 0.01) or atrial fibrillation (18.9% vs 10.3%; P = <0.01). Our study shows that older patients are more likely to have colon ischaemia-associated conditions that are chronic and complex, while younger patients are more likely to have acute colon ischaemia-associated conditions.

Sections du résumé

BACKGROUND
Colon ischaemia is a common disease which has been associated with various medications and comorbidities.
AIM
To test the hypothesis that there are differences in the frequencies of these associations in older compared with younger patients.
METHODS
A retrospective cohort study was performed of patients hospitalized with colon ischaemia at two major medical centres from 2005-2017. Clinical, colonoscopic and pathologic criteria were used to identify patients admitted with colon ischaemia; patients with other types of colitis were excluded. Demographic and medical data were extracted. Two cohorts were created: patients aged 18-64 years and patients > 65 years. These were compared using SAS 14.3.
RESULTS
A total of 788 patients were included, of which 271 (34.4%) were of ages 18-64 years, and 517 (66.6%) were 65 years old or older. In the older cohort, constipation-inducing medications (83.8% vs 64.1%; P = <0.0001), diuretics (38.1% vs 25.1%; P = <0.001) and nonsteroidal anti-inflammatory drugs (58% vs 41.5%; P = <0.0001) were more common than in the younger cohort. Antipsychotic medication use was more common in the younger cohort (10.4% vs 5.4%; P = 0.01). There was a higher percentage of younger patients with a history of hypercoaguable state (1.9% vs 0.2%; P = 0.03) and dialysis dependence (22.9% vs 8.7%; P = <0.01), while a higher percentage of patients in the older cohort had a history of chronic obstructive pulmonary disease (12% vs 6.3%; P = 0.01) or atrial fibrillation (18.9% vs 10.3%; P = <0.01).
CONCLUSIONS
Our study shows that older patients are more likely to have colon ischaemia-associated conditions that are chronic and complex, while younger patients are more likely to have acute colon ischaemia-associated conditions.

Identifiants

pubmed: 31020678
doi: 10.1111/apt.15268
doi:

Substances chimiques

Anti-Inflammatory Agents, Non-Steroidal 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1502-1508

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© 2019 John Wiley & Sons Ltd.

Auteurs

Michael Silverman (M)

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH.

Olga C Aroniadis (OC)

Division of Gastroenterology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.

Paul Feuerstadt (P)

Division of Gastroenterology, Yale University School of Medicine, New Haven, Connecticut.
Gastroenterology Center of Connecticut, Hamden, Connecticut.

Marc Fenster (M)

Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Tsipora Huisman (T)

Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Muhammad Sohail Mansoor (MS)

Department of Internal Medicine, Yale New Haven Hospital, New Haven, Connecticut.

Abdul Qadir Bhutta (AQ)

Department of Internal Medicine, Yale New Haven Hospital, New Haven, Connecticut.

Lawrence J Brandt (LJ)

Division of Gastroenterology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.

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Classifications MeSH