In-hospital mortality for toxic megacolon

Excerpt

Toxic megacolon (TM) is a life-threatening condition that develops when severe colonic inflammation originating from any kind of mucosal injury (immune-mediated, infective, ischaemic, neoplastic, iatrogenic) causes muscular atony and systemic toxicity [1]. Despite its reduced prevalence, the outcome is still unsatisfactory, and a substantial number of patients undergo colectomy. In this context, the paper by Doshi and coworkers [2], reporting the results of the analysis of the data collected in the Nationwide Inpatient Sample database from January 2010 through December 2014, is of interest and offers some food for thought. Obviously, it has some intrinsic weaknesses related to the retrospective design of the study, the absence of a control group, and the overestimation of the prevalence of TM due to the lack of differentiation between first admission and subsequent re-admission of the same patient. Nonetheless, the identification of those factors associated with a poor outcome deserves some comments. …