59 The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta-Analysis

Jones, Jeffrey A.; Cudnik, Michael T.; Stockton, Sherrill W.; Macedo, Julian; Darbha, Subrahmanyam; Hiestand, Brian

doi:10.1016/j.annemergmed.2012.06.338

Cited by 4 publications

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“…An interruption of the blood supply to the mesenteric vasculature can cause necrosis of the small intestine, which can subsequently lead to serious illness and death. The shortterm mortality of AMI is high, ranging from 26 to 86% [2][3][4], and early diagnosis and timely treatment essential to improve the prognosis of AMI [5].…”

Section: Introductionmentioning

confidence: 99%

A rapid preliminary prediction model for intestinal necrosis in acute mesenteric ischemia: a retrospective study

et al. 2021

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Background Acute mesenteric ischemia (AMI) is a life-threatening condition. However, there is no accurate method to predict intestinal necrosis in AMI patients that may facilitate early surgical intervention. This study thus aimed to explore a simple and accurate model to predict intestinal necrosis in patients with AMI. Methods A single-center retrospective study was performed on the data of 132 AMI patients treated between October 2011 and June 2020. The patients were divided into the intestinal necrosis and non-intestinal necrosis groups. The clinical characteristics and laboratory data were analyzed by univariate analysis, and the variables with statistical significance were further analyzed by multivariate logistic regression analysis. The independent predictors of intestinal necrosis were determined and a logistic prediction model was established. Finally, the accuracy, sensitivity, and specificity of the model in predicting intestinal necrosis were evaluated. Results Univariate analysis showed that white blood cell (WBC) count, blood urea nitrogen (BUN) level, neutrophil ratio, prothrombin time (PT), and LnD-dimer were associated with intestinal necrosis. According to logistic regression multivariate analysis, WBC count, BUN level and LnD-dimer were independent predictors of intestinal necrosis. These parameters were used to establish a clinical prediction model of intestinal necrosis (CPMIN) as follows: model score = 0.349 × BUN (mmol/L) + 0.109 × WBC × 109 (109/L) + 0.394 × LnD − Dimer (ug/L) − 7.883. The area under the receiver operating characteristics (ROC) curve of the model was 0.889 (95% confidence interval: 0.833–0.944). Model scores greater than − 0.1992 predicted the onset of intestinal necrosis. The accuracy, specificity, and sensitivity of the model were 82.6%, 78.2%, and 88.3%, respectively. The proportion of intestinal necrosis in the high-risk patient group (CPMIN score ≥ − 0.1992) was much greater than that in the low-risk patient group (CPMIN score < − 0.1992; 82.7% vs. 15.0%, p < 0.001). Conclusion The CPMIN can effectively predict intestinal necrosis and guide early surgical intervention to improve patient prognosis. Patients with AMI who are classified as high-risk should be promptly treated with surgery to avoid the potential complications caused by delayed operation. Patients classified as low-risk group can receive non-surgical treatment. This model may help to lower the morbidity and mortality from AMI. However, this model’s accuracy should be validated by larger sample size studies in the future.

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Section: Introductionmentioning

confidence: 99%

A rapid preliminary prediction model for intestinal necrosis in acute mesenteric ischemia: a retrospective study

et al. 2021

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“…An interruption of the blood supply to the mesenteric vasculature can cause necrosis of the small intestine, which can subsequently lead to serious illness and death. The short-term mortality of AMI is high, ranging from 26 to 86% [2][3][4] , and early diagnosis and timely treatment essential to improve the prognosis of AMI [5] .…”

Section: Introductionmentioning

confidence: 99%

A Rapid Prediction Model for Intestinal Necrosis in Acute Mesenteric Ischemia: A Retrospective Study

Zhuang¹,

Chen²,

Zhou³

et al. 2021

Preprint

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Background：Acute mesenteric ischemia (AMI) is a life-threatening condition. However, there is no accurate method to predict intestinal necrosis in AMI patients that may facilitate early surgical intervention. This study thus aimed to explore a simple and accurate model to predict intestinal necrosis in patients with AMI.Methods: A single-center retrospective study was performed on the data of 132 AMI patients treated between October 2011 and June 2020. The patients were divided into the intestinal necrosis and non-intestinal necrosis groups. The clinical characteristics and laboratory data were analyzed by univariate analysis, and the variables with statistical significance were further analyzed by multivariate logistic regression analysis. The independent predictors of intestinal necrosis were determined and a logistic prediction model was established. Finally, the accuracy, sensitivity, and specificity of the model in predicting intestinal necrosis were evaluated. Results: Univariate analysis showed that white blood cell (WBC) count, blood urea nitrogen (BUN) level, neutrophil ratio, prothrombin time (PT), and LnD-dimer were associated with intestinal necrosis. According to logistic regression multivariate analysis, WBC count, BUN level and LnD-dimer were independent predictors of intestinal necrosis. These parameters were used to establish a clinical prediction model of intestinal necrosis (CPMIN) as follows: model score = 0.349×BUN (mmol/L) +0.109×WBC×109+0.394×LnD-Dimer-7.883. The area under the receiver operating characteristics (ROC) curve of the model was 0.889 (95% confidence interval: 0.833–0.944). Model scores greater than -0.1992 predicted the onset of intestinal necrosis. The accuracy, specificity, and sensitivity of the model were 82.6%, 78.2%, and 88.3%, respectively. The proportion of intestinal necrosis in the high-risk patient group (CPMIN score ≥ -0.1992) was much greater than that in the low-risk patient group (CPMIN score < -0.1992; 82.7% vs. 15.0%, p<0.001).Conclusion：The CPMIN can effectively predict intestinal necrosis and guide early surgical intervention to improve patient prognosis. Patients with AMI who are classified as high-risk should be promptly treated with surgery to avoid the potential complications caused by delayed operation. Patients classified as low-risk group can receive non-surgical treatment. This model may help to lower the morbidity and mortality from AMI.

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Single Best Answer Questions for the Final FFICM

Davies

Gough

King

et al. 2016

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Welcome to the Anaesthesia and Intensive Care books catalogue 2016. Here you will fi nd new and forthcoming titles, representing the highest level of clinical practice and translational research. Our highlights this year include Returning to Work in Anaesthesia and a fourth edition of Fundamentals of Anaesthesia. We also have several new revision books for the FFICM and FRCA and have included in this catalogue a selection of some of our most popular titles from recent years. Our publications are available in a variety of formats, including ebooks and print, as well as online collections for institutional purchase via our publishing service University Publishing Online. To see more book listings, product information, extracts and reviews, you can fi nd us online at www.cambridge.org/medicine You can also keep up to date with the latest news and author views by visiting our Cambridge Medicine blog at www.cambridgemedicine.wordpress.com We are always interested in exploring new ideas for books and digital resources, for both specialty trainees and experienced anaesthetists and intensivists, and would be very pleased to talk to you about any new publishing possibilities. You can fi nd a list of useful contacts by going to www.cambridge.org/meditors We hope that you enjoy reading about our latest publications.

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59 The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 0 publications

A rapid preliminary prediction model for intestinal necrosis in acute mesenteric ischemia: a retrospective study

A rapid preliminary prediction model for intestinal necrosis in acute mesenteric ischemia: a retrospective study

A Rapid Prediction Model for Intestinal Necrosis in Acute Mesenteric Ischemia: A Retrospective Study

Single Best Answer Questions for the Final FFICM

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