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  • Acosta, StefanLund University,Lunds universitet,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Department of Clinical Sciences, Malmö,Faculty of Medicine,Vascular Diseases - Clinical Research,Lund University Research Groups (author)

Fatal colonic ischaemia : A population-based study

  • Article/chapterEnglish2006

Publisher, publication year, extent ...

  • 2009-07-08
  • Informa UK Limited,2006
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-10972
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-10972URI
  • https://doi.org/10.1080/00365520600670042DOI
  • https://lup.lub.lu.se/record/162178URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objectives. To estimate the incidence of fatal colonic ischaemia (CI) and the cause-specific mortality of CI, and to describe the localization and extension of colonic infarction and quantify the risk factors associated with CI. Material and methods. Between 1970 and 1982 the autopsy rate in Malmo, Sweden, was 87%, creating the possibilities for a population-based study. Out of 23,446 clinical autopsies, 997 cases were coded for intestinal ischaemia in a database. In addition, 7569 forensic autopsy protocols were analysed. In a case-control study nested in the clinical autopsy cohort, four CI-free controls, matched for gender, age at death and year of death, were identified for each fatal CI case in order to evaluate the risk factors. Results. The cause-specific mortality ratio was 1.7/1000 autopsies. The overall incidence of autopsy-verified fatal CI was 1.7/100,000 person years, increasing with age up to 23/100,000 person years in octogenarians. Fatal cardiac failure (odds ratio (OR) 5.2), fatal valvular disease (OR 4.3), previous stroke (OR 2.5) and recent surgery (OR 3.4) were risk factors for fatal CI. Narrowing/occlusion of the inferior mesenteric artery (IMA) at the aortic origin was present in 68% of the patients. The most common segments affected by transmural infarctions were the sigmoid (83%) and the descending (77%) colon. Conclusions. Heart failure, atherosclerotic occlusion/stenoses of the IMA and recent surgery were the main risk factors causing colonic hypoperfusion and infarction. Segments of transmural infarctions were observed within the left colon in 94% of the patients. Awareness of the diagnosis and its associated cardiac comorbidities might help to improve survival.

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  • Ögren, MatsUppsala universitet,Kärlkirurgi (author)
  • Sternby, Nils-Herman (author)
  • Bergqvist, DavidUppsala universitet,Kärlkirurgi(Swepub:uu)daviberg (author)
  • Björck, MartinUppsala universitet,Kärlkirurgi(Swepub:uu)mabjo425 (author)
  • Institutionen för kliniska vetenskaper, MalmöMedicinska fakulteten (creator_code:org_t)

Related titles

  • In:Scandinavian Journal of Gastroenterology: Informa UK Limited41:11, s. 1312-13190036-55211502-7708

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