Lebensbedrohliche Komplikationen von Morbus Crohn und Colitis ulcerosa. Eine systematische Auswertung von Intensiv-Aufnahmen über 18 Jahre
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Lebensbedrohliche Komplikationen von Morbus Crohn und Colitis ulcerosa. Eine systematische Auswertung von Intensiv-Aufnahmen über 18 Jahre. / Huber, W; Herrmann, G; Schuster, T; Phillip, V; Saugel, B; Schultheiss, C; Hoellthaler, J; Gaa, J; Hartel, M; Schmid, R M; Reindl, W.
in: DEUT MED WOCHENSCHR, Jahrgang 135, Nr. 14, 01.04.2010, S. 668-74.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Lebensbedrohliche Komplikationen von Morbus Crohn und Colitis ulcerosa. Eine systematische Auswertung von Intensiv-Aufnahmen über 18 Jahre
AU - Huber, W
AU - Herrmann, G
AU - Schuster, T
AU - Phillip, V
AU - Saugel, B
AU - Schultheiss, C
AU - Hoellthaler, J
AU - Gaa, J
AU - Hartel, M
AU - Schmid, R M
AU - Reindl, W
N1 - Georg Thieme Verlag KG Stuttgart, New York.
PY - 2010/4/1
Y1 - 2010/4/1
N2 - BACKGROUND AND OBJECTIVE: Despite numerous publications on the epidemiology of inflammatory bowel diseases (IBD) there is a lack of systematic investigations on live-threatening complications of IBD and their causes. This study evaluates risk factors, course and outcome in intensive-care patients which were related to complications of IBD.PATIENTS AND METHODS: Among 6071 admissions to the intensive-care unit (ICU) of a gastroenterological department (university hospital with IBD-outpatient unit) between 1.1.1991 and 31.1.2008 36 ICU admissions of 28 patients with IBD were documented and prospectively analysed from 1996 onwards, using a structured questionnaire on causes for ICU admission as well as risk factors regarding death, organ failure and length of ICU stay.RESULTS: ICU admissions of IBD patients mainly resulted from three causes: complications specific to IBD (44 %), including acute flare-up, perforation and electrolyte imbalance, septic complications (22 %) and thromboembolic complications (17 %). Five patients died, all from septic complications related to immunosuppression including candida sepsis, varicella pneumonia during treatment with infliximab, and pneumocystis pneumonia related to treatment with azathioprine. The most important risk factors according to uni- and multivariate analyses were old age on ICU-admission and first diagnosis of IBD, previous surgery related to IBD and Crohn's disease.CONCLUSIONS: Complications of both IBD and immunosuppressive therapy may be live-threatening in patients with IBD. Better characterization of patients with a high probability of improved outcome by immunosuppressive and/or antibody-therapy seems to be preferable to noncritical early use of these drugs.
AB - BACKGROUND AND OBJECTIVE: Despite numerous publications on the epidemiology of inflammatory bowel diseases (IBD) there is a lack of systematic investigations on live-threatening complications of IBD and their causes. This study evaluates risk factors, course and outcome in intensive-care patients which were related to complications of IBD.PATIENTS AND METHODS: Among 6071 admissions to the intensive-care unit (ICU) of a gastroenterological department (university hospital with IBD-outpatient unit) between 1.1.1991 and 31.1.2008 36 ICU admissions of 28 patients with IBD were documented and prospectively analysed from 1996 onwards, using a structured questionnaire on causes for ICU admission as well as risk factors regarding death, organ failure and length of ICU stay.RESULTS: ICU admissions of IBD patients mainly resulted from three causes: complications specific to IBD (44 %), including acute flare-up, perforation and electrolyte imbalance, septic complications (22 %) and thromboembolic complications (17 %). Five patients died, all from septic complications related to immunosuppression including candida sepsis, varicella pneumonia during treatment with infliximab, and pneumocystis pneumonia related to treatment with azathioprine. The most important risk factors according to uni- and multivariate analyses were old age on ICU-admission and first diagnosis of IBD, previous surgery related to IBD and Crohn's disease.CONCLUSIONS: Complications of both IBD and immunosuppressive therapy may be live-threatening in patients with IBD. Better characterization of patients with a high probability of improved outcome by immunosuppressive and/or antibody-therapy seems to be preferable to noncritical early use of these drugs.
KW - Adult
KW - Aged
KW - Cause of Death
KW - Colitis, Ulcerative
KW - Crohn Disease
KW - Female
KW - Germany
KW - Hospital Mortality
KW - Hospitals, University
KW - Humans
KW - Intensive Care Units
KW - Length of Stay
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Recurrence
KW - Retrospective Studies
KW - Risk Factors
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1055/s-0030-1251915
DO - 10.1055/s-0030-1251915
M3 - SCORING: Zeitschriftenaufsatz
C2 - 20358493
VL - 135
SP - 668
EP - 674
JO - DEUT MED WOCHENSCHR
JF - DEUT MED WOCHENSCHR
SN - 0012-0472
IS - 14
ER -