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Sunday Poster Session

Category: Colon

P0190 - Patients with Ischemic Colitis and Obesity Present at a Younger Age but Do Not Have Worse Outcomes

Sunday, October 22, 2023
3:30 PM – 7:00 PM PT
Location: Exhibit Hall
Luis M. Nieto, MD1, Sharon I. Narvaez, MD2, John Martinez, MPH2, Frank J. Lukens, MD3, Steven Keilin, MD4, Laura Davisson, MD5, Pedro Palacios, MD3, Shailendra Singh, MD5
1WellStar Health System-Cobb Medical Center, Atlanta, GA; 2WellStar Cobb Medical Center, Atlanta, GA; 3Mayo Clinic Florida, Jacksonville, FL; 4Emory University School of Medicine, Atlanta, GA; 5West Virginia University, Morgantown, WV

Introduction: Obesity is a global pandemic, with a prevalence of more than 40% in the USA. Ischemic colitis (IC) is the most common cause of intestinal ischemia and is associated with significant morbidity and mortality, particularly with advanced age. There is a paucity of data on the impact of obesity on ischemic colitis. Therefore, we aim to evaluate the outcomes of ischemic colitis in patients with obesity.

Methods: We performed a retrospective cohort utilizing the 2016-2019 National Inpatient Sample to identify patients discharged with IC using ICD10-CM/PCS codes. Patients were categorized into two groups based on the presence of obesity. The primary outcomes examined were mortality, the need for colonoscopy, and colectomy. Secondary outcomes included length of stay (LOS), health-care-related charges and costs adjusted to inflation according to the price consumer index for the year 2019. Multivariate regression analysis adjusted for patient and hospital characteristics was performed for the primary and secondary outcomes.

Results: A total of 107,001 discharges for IC were identified. 13.7 % of patients had a secondary diagnosis of obesity. Obese patients with IC were younger (65.7 vs 70.7, p = < 0.01) and had higher rates of diabetes type 2 (DM2) (39.5% vs 22.9%, p = < 0.01), had higher rates of colonoscopy (51.6% vs 44.9%, p = < 0.01) and need for colectomy (46.6% vs 40.0%, p = < 0.01). Results are displayed in Table 1. On multivariate analysis, there were no differences in mortality, need for colonoscopy or colectomy, LOS and health-care-related charges and costs between the two groups.

Discussion: A large proportion of patients with IC have obesity as a comorbidity. Obesity is associated with IC at a younger age, likely due to associated comorbidities and underlying atherosclerotic disease. However, obesity was not independently associated with worse in-hospital outcomes. Further prospective studies are needed.

Table 1. General characteristics of patients with Ischemic Colitis

 

Ischemic Colitis in Adults without Obesity

Ischemic Colitis in Adults with Obesity

P value

Patient characteristics (%)

No. of patients

88,887

18,114

 

Female (%)

73.1

73.2

0.96

Mean age, years

70.7

65.7

< 0.01

Admission characteristics (%)

Weekend

27.7

28.6

0.68

Race (%)

White

83.1

82.3

0.07

African American

6.7

7.9

Hispanic

5.6

7.4

Asian

2.6

0.8

Native American

0.3

0.4

Other

1.5

1.0

Charlson Comorbidity index score (%)

0

30.5

26.6

 

< 0.01

1

25.2

20.2

2

17.4

17.9

≥ 3

26.9

35.3

Median annual income in patient’s zip code, US$ (%)

0 to 25th percentile

23.2

25.1

0.34

26 to 50th percentile

27.1

26.1

51 to 75th percentile

26.3

28.5

76 to 100th percentile

23.4

20.3

Insurance type, (%)

Medicare

72.7

66.1

 

< 0.01

Medicaid

5.9

9.9

Private

19.7

23.3

Self-pay

1.7

0.7

Hospital Region (%)

Northeast

21.9

19.8

 

0.01

Midwest

25.1

31.7

South

35.8

30.9

West

17.1

17.7

Hospital bed size (%)

Small

22.1

20.9

 

0.77

Medium

31.5

31.1

Large

46.3

47.9

Hospital Location (%)

Rural

10.1

10.3

0.89

Urban

89.8

89.7

Teaching status (%)

Non- teaching

36.6

37.6

0.68

Teaching

63.4

62.4

Patient comorbidities (%)

DM2

22.9

39.5

< 0.01

Alcohol abuse

2.2

3.0

0.30

History of smoking

0.7

1.2

0.23

Cannabis

0.9

1.4

0.31

Opioid abuse

1.5

2.0

0.38

Malnutrition

0.8

0.5

0.01

HIV

0.1

0.2

0.68

Vit D deficiency

1.4

2.4

0.09

Inpatient complications (%)

Mechanical Ventilation

0.8

1.4

0.22

Acute kidney injury

22.6

25.8

0.11

Parenteral Nutrition

2.3

2.0

0.65

Ileus

0.1

0.2

0.83

In-patient procedure (%)

Colonoscopy

44.9

51.6

< 0.01

Colonoscopy with procedure

40.0

46.6

< 0.01

Colectomy

6.9

7.7

0.52

Health-care related usage

Length of stay (days), mean

5.4

5.9

0.09

Charges ($), mean

57,960.33

62,985.9

0.31

Costs ($), mean

14,334.94

16,459.6

0.09



Disclosures:
Luis Nieto indicated no relevant financial relationships.
Sharon Narvaez indicated no relevant financial relationships.
John Martinez indicated no relevant financial relationships.
Frank Lukens indicated no relevant financial relationships.
Steven Keilin indicated no relevant financial relationships.
Laura Davisson indicated no relevant financial relationships.
Pedro Palacios indicated no relevant financial relationships.
Shailendra Singh indicated no relevant financial relationships.


Luis M. Nieto, MD1, Sharon I. Narvaez, MD2, John Martinez, MPH2, Frank J. Lukens, MD3, Steven Keilin, MD4, Laura Davisson, MD5, Pedro Palacios, MD3, Shailendra Singh, MD5. P0190 - Patients with Ischemic Colitis and Obesity Present at a Younger Age but Do Not Have Worse Outcomes, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.