Risk factors for intestinal ischaemia among patients registered in a UK primary care database: a nested case-control study

Aliment Pharmacol Ther. 2011 Apr;33(8):969-78. doi: 10.1111/j.1365-2036.2011.04614.x. Epub 2011 Mar 1.

Abstract

Background: Intestinal ischaemia, including ischaemic colitis and acute mesenteric ischaemia, causes significant morbidity and mortality. Few population-based studies have estimated incidence and potential risk factors for this disease.

Aims: To estimate the incidence of intestinal ischaemia and identify the associated risk factors in cohorts: (i) patients with irritable bowel syndrome and/or chronic constipation (IBS/CC/both), (ii) individuals free of these conditions.

Methods: Population-based case-control analysis nested in a cohort of patients with first ever recorded diagnosis of IBS/CC/both and a cohort free of these conditions from general population using the General Practice Research Database.

Results: Of 78 cases of intestinal ischaemia, 71 were from general population, seven from the IBS/CC/both cohort. Incidence rate of intestinal ischaemia in IBS/CC/both patients vs. general population was 4.49:1.09 per 100,000 person-years; age- and gender-adjusted incidence rate ratio (95% CI) was 2.7 (1.2-5.9). Inflammatory bowel disease and heart failure showed an association with ischaemic colitis [OR (95% CI): 4.2 (0.5-38.4) and 5.6 (2.2-14.1)], but none with acute mesenteric ischaemia. Diabetes and prior cardiovascular surgery were associated with higher risk of acute mesenteric ischaemia, but showed no association with ischaemic colitis.

Conclusions: Results suggest that different risk factors are associated with acute mesenteric ischaemia and ischaemic colitis. However, due to small number of patients, associations should be carefully interpreted.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Colitis, Ischemic / etiology*
  • Constipation / epidemiology
  • Female
  • Humans
  • Incidence
  • Intestines / blood supply*
  • Irritable Bowel Syndrome / epidemiology
  • Ischemia / etiology*
  • Male
  • Mesenteric Ischemia
  • Middle Aged
  • Primary Health Care
  • Risk Factors
  • United Kingdom / epidemiology
  • Vascular Diseases / etiology