Outcomes of Vasoconstrictor-Induced Non-Occlusive Mesenteric Ischemia of Colon: A Systematic Review.
Cocaine
Iatrogenic Disease
In-Hospital Mortality
Intestinal ischemia
Length of Stay
Patient Outcome Assessment
Journal
Clinical medicine & research
ISSN: 1554-6179
Titre abrégé: Clin Med Res
Pays: United States
ID NLM: 101175887
Informations de publication
Date de publication:
08 Jun 2022
08 Jun 2022
Historique:
received:
01
11
2021
revised:
04
02
2022
accepted:
22
03
2022
entrez:
8
6
2022
pubmed:
9
6
2022
medline:
9
6
2022
Statut:
aheadofprint
Résumé
Nonocclusive mesenteric ischemia (NOMI) is due to mesenteric arterial hypoperfusion from several causes, such as hypovolemia, heart failure, shock, vasoconstrictors, and severe liver or renal disease. Vasoconstrictor-induced NOMI is usually iatrogenic or associated with cocaine use. Anecdotal reports suggest that cocaine-induced NOMI has the highest mortality among vasoconstrictors. This review aims to compare the outcomes of colonic NOMI secondary to cocaine versus other vasoconstrictors. We conducted a systematic search of MEDLINE from inception through October 2016 to find articles on colonic NOMI. The study's primary outcomes were mortality and hospital length of stay (LOS), while secondary outcomes included the need for surgery. We reported descriptive statistics as percentages or median and interquartile range (IQR). We compared continuous data with the Mann-Whitney test and categorical data with Fisher's exact test; Of the 59 studies, 20 case reports and 3 case series (n= 27 patients) met the inclusion criteria. There was no difference in mortality between cocaine-induced NOMI and non-cocaine NOMI ( Cocaine-induced NOMI and non-cocaine NOMI both appear to have a relatively high but similar mortality rate, but the former is associated with increased requirement for surgery and LOS; prompt recognition of this clinical entity is required to improve outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Nonocclusive mesenteric ischemia (NOMI) is due to mesenteric arterial hypoperfusion from several causes, such as hypovolemia, heart failure, shock, vasoconstrictors, and severe liver or renal disease. Vasoconstrictor-induced NOMI is usually iatrogenic or associated with cocaine use.
OBJECTIVES
OBJECTIVE
Anecdotal reports suggest that cocaine-induced NOMI has the highest mortality among vasoconstrictors. This review aims to compare the outcomes of colonic NOMI secondary to cocaine versus other vasoconstrictors.
METHODS
METHODS
We conducted a systematic search of MEDLINE from inception through October 2016 to find articles on colonic NOMI. The study's primary outcomes were mortality and hospital length of stay (LOS), while secondary outcomes included the need for surgery. We reported descriptive statistics as percentages or median and interquartile range (IQR). We compared continuous data with the Mann-Whitney test and categorical data with Fisher's exact test;
RESULTS
RESULTS
Of the 59 studies, 20 case reports and 3 case series (n= 27 patients) met the inclusion criteria. There was no difference in mortality between cocaine-induced NOMI and non-cocaine NOMI (
CONCLUSION
CONCLUSIONS
Cocaine-induced NOMI and non-cocaine NOMI both appear to have a relatively high but similar mortality rate, but the former is associated with increased requirement for surgery and LOS; prompt recognition of this clinical entity is required to improve outcomes.
Identifiants
pubmed: 35676075
pii: cmr.2022.1726
doi: 10.3121/cmr.2022.1726
pmc: PMC9544191
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2022 Marshfield Clinic Health System.
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