Intest Res.  2015 Apr;13(2):128-134. 10.5217/ir.2015.13.2.128.

What's the Clinical Features of Colitis in Elderly People in Long-Term Care Facilities?

• Yoon SY
• Jung SA
• Na SK
• Ryu JI
• Yun HW
• Lee MJ
• Song EM
• Kim SE
• Jung HK
• Shim KN

• KMID: 2284879
• DOI: http://doi.org/10.5217/ir.2015.13.2.128

Abstract

BACKGROUND/AIMS
As life expectancy has increased, the number of elderly patients who need long-term care has grown rapidly. Mortality in patients with colitis in long-term care facilities (LTCFs) is increasing. We intend to investigate the main causes of colitis in LTCFs compared to those of colitis in local communities, and to identify the clinical features and risk factors of patients with colitis in LTCFs.
METHODS
We retrospectively analyzed epidemiology, medical conditions, laboratory values, diagnoses, and clinical courses of elderly patients aged > or =65 who were admitted to the Ewha Womans University hospital with colitis between January 2007 and July 2012.
RESULTS
Patients with colitis in LTCFs (n=20) were compared with elderly patients with colitis in local communities (n=154). Fifty-five percent of colitis in LTCFs was caused by Clostridium difficile infection (CDI), 30% was due to ischemic colitis, and 15% was due to non-specific colitis. Non-specific colitis was the most common (63%) in the community group. Clinical outcomes were also significantly different between both groups: higher mortality (10.0% vs. 0.64%, P=0.021), higher requirement for intensive care units care (50.0% vs. 18.8%, P<0.01) in LTCFs group. In univariate analysis, the most significant risk factor for death in patients in LTCFs was decreased mental faculties.
CONCLUSIONS
Patients in LTCFs showed worse clinical outcomes and a much higher prevalence of CDI compared to patients from local communities. We suggest early and active evaluation, such as endoscopic examination, for differential diagnosis in patients in LTCFs.

Keyword

Colitis; Long-term care; Clostridium difficile

MeSH Terms

Aged*
Clostridium difficile
Colitis*
Colitis, Ischemic
Diagnosis
Diagnosis, Differential
Epidemiology
Female
Humans
Intensive Care Units
Life Expectancy
Long-Term Care*
Mortality
Prevalence
Retrospective Studies
Risk Factors

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