Glasgow coma scale score and albumin level are associated with patient survival after emergent colonoscopy in the intensive care unit

Abstract

Due to poor patient condition and the high risk associated with the procedure, colonoscopy is rarely performed in the intensive care unit (ICU). It is indicated for ICU patients with suspected ischemic colitis, decompression of colonic distension, or lower gastrointestinal hemorrhage. ICU patients usually have more co-morbidities and higher mortality rates than other inpatient patients. Data in the literature regarding the outcomes of ICU patients after colonoscopy are limited. The aim of this study was to identify factors that are predictive of outcomes following colonoscopy in ICU patients. We retrospectively analyzed the medical records and imaging findings of patients who underwent colonoscopy in an ICU setting between January 2018 and June 2020. A total of 79 patients were identified and enrolled for analysis. The median age of the patients was 78 years. The colonoscopy findings included angiodysplasia (n = 3, 3.8%), colitis (n = 17, 21.5%), colonic ulcer (n = 2, 2.5%), diverticulosis (n = 3, 3.8%), hemorrhoid (n = 10, 12.7%), rectal ulcer (n = 16, 20.3%), tumor (n = 10, 12.7%), volvulus (n = 1, 1.3%), bleeding of unknown origin (n = 4, 5.1%), and no diagnosis (n = 13, 16.5%). A total of 46 patients (58%) survived to discharge. Patients who survived had statistically significantly higher Glasgow coma scale (GCS) scores (P = .009) and albumin levels (P = .002) than patients who did not survive. Patient survival is associated with GCS score and albumin level, but not with colonoscopy findings.