Prognostic Factors in Non-occlusive mesenteric ischemia: A pragmatic pre-operative score for the prediction of 28-day mortality.
Computed tomography
Critical care
Non-occlusive mesenteric ischemia
Prognosis
Small bowel
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
12
10
2021
revised:
08
02
2022
accepted:
25
03
2022
pubmed:
7
4
2022
medline:
28
6
2022
entrez:
6
4
2022
Statut:
ppublish
Résumé
The prognosis of critical ill patients with non-occlusive mesenteric ischemia (NOMI) is poor and not fully understood. We aimed to determine preoperative factors associated with 28-day mortality in NOMI. Variables associated with 28-day mortality were entered into a multivariate cox regression model and were used to compute a NOMI mortality score. 154 patients were included. The 28-day mortality rate was 56%. Multivariable analyses including variables at the time of the CT identified three variables (i.e. lactates > 7 mmoL/l, prothrombin rate <60% and kidney infarction), included in a simple score. Among the study population, the probability of 28-day mortality was 26% (11/42), 54% (26/48), 77% (23/30) and 100% (21/21) for a survival score of 0, 1, 2 and 3, respectively. A simple score combining these three variables, calculated preoperatively, was able to accurately predict 28-day mortality and might help to avoid futile laparotomies.
Sections du résumé
BACKGROUND
The prognosis of critical ill patients with non-occlusive mesenteric ischemia (NOMI) is poor and not fully understood. We aimed to determine preoperative factors associated with 28-day mortality in NOMI.
METHODS
Variables associated with 28-day mortality were entered into a multivariate cox regression model and were used to compute a NOMI mortality score.
RESULTS
154 patients were included. The 28-day mortality rate was 56%. Multivariable analyses including variables at the time of the CT identified three variables (i.e. lactates > 7 mmoL/l, prothrombin rate <60% and kidney infarction), included in a simple score. Among the study population, the probability of 28-day mortality was 26% (11/42), 54% (26/48), 77% (23/30) and 100% (21/21) for a survival score of 0, 1, 2 and 3, respectively.
CONCLUSION
A simple score combining these three variables, calculated preoperatively, was able to accurately predict 28-day mortality and might help to avoid futile laparotomies.
Identifiants
pubmed: 35382932
pii: S0002-9610(22)00226-4
doi: 10.1016/j.amjsurg.2022.03.048
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
617-623Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.