Ischemic colitis in the elderly: predictive factors of gangrenous outcome

Objective - To better characterize the presentation of gangrenous and non-g angrenous ischemic colitis irt,subjects older than 60 years, and to identif y risk factors of gangrenous outcome. Methods-Retrospective analysis of 80 cases of ischemic colitis (22 male, 58 female; mean age 76.9 +/- 8.7 years) with 64 and 16 non gangrenous and gan grenous forms, respectively: Results - Hematochezia and diarrhea were significantly less prevalent in ga ngrenous colitis compared to the nongangrenous group (31.2% vs 81.2%, P<0.0 001 and 6.2% vs 53.1%, P < 0.0001, respectively), whereas nausea and vomiti ng, and hyperleucocytosis were significantly more frequent in the former gr oup (50.0% vs 18.7%, P<0.01 and 93.7% vs 62.5%, P < 0.02 respectively). Hyp ertension (P < 0.03), angina (P < 0.05), history of cancer (P < 0.03) and a ge older than 90 (P < 0.002) were risk factors for gangrenous outcome. Afte r multivariate analysis, only two independent factors were identified Br hy pertension and history of cancer. These factors predicted gangrenous course in 85% of cases. Conclusion-Patients older than 60 years suffering from ischemic colitis are at high risk of gangrenous course if they have hypertension or history of cancer.