[Predictive factors of mortality in severe ischaemic colitis: post-operative analysis of 101 patients].

Introduction: Ischaemic colitis (IC) is the most common form of bowel ischaemia and is often under-diagnosed.

Objectives: To report the results obtained in patients with IC who required surgical intervention in our Hospital, and to evaluate the predictive factors of mortality.

Methods: The data were obtained from the Gregorio Marañon Hospital CI database. The demographic and clinical characteristics, diagnostic methods, surgical techniques employed and mortality were analysed statistically, using the chi(2) and Student t test.

Results: One-hundred and one patients with CI were operated on between 1991 and 2006. The majority of them had cardiovascular histories and 35 cases were diagnosed during their hospital stay due to another cause. The signs and the symptoms were non-specific in 40% of the cases. Total morbidity and mortality was 39.6% and 41.6% respectively. In the post-operative IC cases, the death rate increased to 68% (p<0.01); 93% of the patients who died had transmural necrosis during the surgery (p<0.05) and 69% had a metabolic acidosis.

Conclusions: The death rate in patients with IC that requires surgery is high, particularly if the diagnosis is made in the post-operative period after surgery for another cause, or if there is evidence of transmural necrosis during the intervention. Early diagnosis is the best tool to improve these results.