Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients with Acute Mesenteric Ischemia.
Acute Disease
Adult
Age Factors
Aged
Body Composition
Clinical Decision Rules
Clinical Decision-Making
Comorbidity
Conservative Treatment
/ adverse effects
Elective Surgical Procedures
Female
Frail Elderly
Frailty
/ diagnostic imaging
Health Status
Humans
Male
Mesenteric Ischemia
/ diagnostic imaging
Mesenteric Vascular Occlusion
/ diagnostic imaging
Middle Aged
Predictive Value of Tests
Psoas Muscles
/ diagnostic imaging
Risk Assessment
Risk Factors
Sarcopenia
/ diagnostic imaging
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures
/ adverse effects
Journal
Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
04
01
2020
revised:
21
02
2020
accepted:
14
03
2020
pubmed:
3
4
2020
medline:
27
10
2020
entrez:
3
4
2020
Statut:
ppublish
Résumé
This study was performed to determine the association of frailty and comorbidity status with postoperative morbidity and mortality in patients with acute mesenteric ischemia (AMI). Patients diagnosed with AMI between April 2006 and September 2019 were enrolled in this study. Frailty was evaluated by sarcopenia which was diagnosed by third lumbar vertebra psoas muscle area (PMA). Comorbidity status was evaluated by the Charlson Comorbidity Index (CCI) score. Univariate and multivariate analyses evaluating the risk factors for postoperative morbidity and mortality were performed. Of the 174 patients, 86 were managed conservatively and 88 underwent surgery. In surgically managed patients, 39.8% developed complications within 30 days of surgery. Ten patients died within 30 days of the operation. In the univariate analyses, white blood cell >10 g/L, low PMA, CCI score ≥2, and bowel resection were associated with postoperative complications. Multivariate analysis revealed that low PMA, CCI score ≥2, and bowel resection were independent predictors of postoperative complications. This study demonstrated that low PMA, CCI score ≥2, and bowel resection were independent risk factors for postoperative complications in patients with AMI. Preoperative assessment of frailty using PMA and the evaluation of comorbidity status using CCI may serve as helpful tools in preoperative risk assessment and should be integrated into scoring systems for surgically treated AMI.
Sections du résumé
BACKGROUND
BACKGROUND
This study was performed to determine the association of frailty and comorbidity status with postoperative morbidity and mortality in patients with acute mesenteric ischemia (AMI).
METHODS
METHODS
Patients diagnosed with AMI between April 2006 and September 2019 were enrolled in this study. Frailty was evaluated by sarcopenia which was diagnosed by third lumbar vertebra psoas muscle area (PMA). Comorbidity status was evaluated by the Charlson Comorbidity Index (CCI) score. Univariate and multivariate analyses evaluating the risk factors for postoperative morbidity and mortality were performed.
RESULTS
RESULTS
Of the 174 patients, 86 were managed conservatively and 88 underwent surgery. In surgically managed patients, 39.8% developed complications within 30 days of surgery. Ten patients died within 30 days of the operation. In the univariate analyses, white blood cell >10 g/L, low PMA, CCI score ≥2, and bowel resection were associated with postoperative complications. Multivariate analysis revealed that low PMA, CCI score ≥2, and bowel resection were independent predictors of postoperative complications.
CONCLUSIONS
CONCLUSIONS
This study demonstrated that low PMA, CCI score ≥2, and bowel resection were independent risk factors for postoperative complications in patients with AMI. Preoperative assessment of frailty using PMA and the evaluation of comorbidity status using CCI may serve as helpful tools in preoperative risk assessment and should be integrated into scoring systems for surgically treated AMI.
Identifiants
pubmed: 32240729
pii: S0890-5096(20)30274-0
doi: 10.1016/j.avsg.2020.03.037
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105-114Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.