Clinical characteristics of ischemic bowel disease in elderly patients / 中华全科医师杂志

ABSTRACT

Objective To analyze the clinical characteristics of ischemic bowel disease in elderly patients.Methods The clinical data of 83 patients with ischemic bowel disease, including 48 patients aged ≥60 years (elderly group ) and 35 patients aged ＜60 years ( control group ), admitted in our hospital from January 2011 to June 2016 were retrospectively analyzed.The clinical characteristics , underlying diseases, examination methods and treatment were compared between the two groups .Results There were no significant differences in gender , occupation, urban or rural origin between the two groups (P＞0.05).The incidence of acute mesenteric ischemia ( AMI) in elderly group was significantly higher than that in the control group [22.9%(11/48) vs.5.7%(2/35), χ2＝4.534, P ＝0.033];while the incidence of ischemic colitis (IC) in control group was higher than that in the elderly group [94.3%(33/35) vs. 70.8%(34/48), χ2＝7.154, P＝0.007].Elderly group was more prone to misdiagnosis as compared with the control group [58.3%(28/48) vs.34.3%(12/35), χ2＝4.688, P ＝0.030] .Abdominal pain, diarrhea and hematochezia were the most common clinical manifestations of the two groups .Moderate pain and dull pain were the main symptoms of the elderly group accounting for 75.0%(36/48), while colic was the main symptoms of the control group accounting for 65.7%(23/35).The proportion of elderly patients with hypertension, coronary heart disease and cerebral infarction was higher than that of the control group [70.8%(34/48)vs.25.7%(9/35),62.5%(30/48) vs.20.0%(7/35),16.7%(8/48) vs.0(0/35), χ2＝16.504,14.798,4.684,all P＜0.05].The number of patients receiving colonoscopic examination was lower in the elderly group than that in the control group [52.1%(25/48) vs.94.3%(33/35), χ2＝17.127, P＝0.000 ] .The overall effective rate of medical treatment for elderly patients was 90.2%(37/41), mostly of them were chronic mesentery ischemia (CMI) and IC patients; while 11 cases of AMI patients had poor outcomes of medical and surgical treatment including 5 fatal cases.Conclusions The incidence and mortality of AMI in elderly patients with ischemic bowel disease are higher , while CMI and IC have good prognosis.Timely diagnosis, appropriate treatment may improve the cure rate and reduce mortality for elderly patients with AMI.