Determinants of mortality and treatment outcome following surgical interventions for acute mesenteric ischemia

Kougias, Panagiotis; Lau, Donald; Sayed, Hosam F. El; Wei, Zhou; Huynh, Thi Thanh Tam; Lin, Peter H.

doi:10.1016/j.jvs.2007.04.045

Cited by 269 publications

(193 citation statements)

References 30 publications

Supporting

Mentioning

155

Contrasting

Unclassified

Order By: Relevance

“…Mean age of AMI patients exceeds 65 years. [12] Kougias et al [13] reported a mean age of 71 years; the mean age of our AMI group was 68.43 years.…”

Section: Discussionmentioning

confidence: 88%

Diagnostic utility of the neutrophil-to-lymphocyte ratio in patients with acute mesenteric ischemia: A retrospective cohort study

Tanrıkulu

Sabuncuoğlu

et al. 2015

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

BACKGROUND: Acute mesenteric ischemia (AMI) remains fatal in 50-70% of cases. AMI is recognized as a vascular emergency, requiring rapid and efficient clinical evaluation and treatment. In the present retrospective study, the possible utility of the neutrophillymphocyte ratio (NLR) in the early diagnosis of AMI was explored. The potential use of this ratio to distinguish AMI from non-vascular bowel necrosis (NVBN) was investigated.

show abstract

“…Mean age of AMI patients exceeds 65 years. [12] Kougias et al [13] reported a mean age of 71 years; the mean age of our AMI group was 68.43 years.…”

Section: Discussionmentioning

confidence: 88%

Diagnostic utility of the neutrophil-to-lymphocyte ratio in patients with acute mesenteric ischemia: A retrospective cohort study

Tanrıkulu

Sabuncuoğlu

et al. 2015

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

show abstract

“…In Swedish autopsy studies, it is shown that real mortality rate of mesenteric ischemia can be more than 90 %, and 33 % of the patients could be diagnosed before death (8). In many studies it is reported that delays in establishing the AMI diagnosis reduce the survival chance and morbidity signifi cantly (4,6,(18)(19)(20). In accordance withthis knowledge, with its high mortality and morbidity rates, acute mesenteric ischemia needs rapid and correct diagnosis in order to begin treatment immediately.…”

Section: Discussionmentioning

confidence: 92%

The place of D-dimer and L-lactate levels in the early diagnosis of acute mesenteric ischemia

Aydın¹,

Ozban²,

Serinken³

et al. 2015

BLL

View full text Add to dashboard Cite

INTRODUCTION: Acute mesenteric ischemia (AMI) is an abdominal-vascular emergency which is rare and has high mortality rates (60-80 %) due to late diagnosis (1-3). Although it is known that extravascular reasons like intestinal intussusception, volvulus, strangulated hernias and obstructions can cause intestinal gangrene, these are rarely the cause of AMI (1). MATERIALS AND METHODS: In this study, we used male Wistar-Albino rats weighing 250-300 grams obtained from Pamukkale University Experimental Research Laboratory. Animals were exposed to light-dark cycles for 12 hours and had free access to food and water. They were kept in cages for 7 days to stabilise their intestinal fl ora. In animals of group I, nothing was made other than taking 0.5 ml blood intracardially. In other animals, abdomen was reached with midline laparotomy and superior mesenteric artery (SMA) was located. In group II (operative control group), SMA was isolated and manipulated but was not ligated. In Group III (intestinal ischemia group), SMAwas isolated and ligated with 3/0 silk tie distally to the aorta. After this process, intestinal ischemia was achieved which was confi rmed by paleness and pulselessness of intestines, caecum and right colon. Later on, abdomen was closed with double 3/0 polyglactin sutures. At postoperative 1st, 4th and 6th hours 0.5 ml blood was taken intracardially from the animals in groups II and III in order to quantify D-dimer and L-lactate levels. LABORATORY TESTS: D-dimer: Blood samples which were put into tubes containing sodium citrate, were seperated from plasma with centrifugation at 4000 rpm for 7 minutes. L-lactate: Blood L-lactate levels were determined from blood taken into capillary tubes with the help of immobilised enzyme electrode technology using YSI 1500 Sport portative lactate analyzer (Yellow Springs Instruments Inc., Ohio-USA). HISTOPATHOLOGIC VERIFICATION: Two cm long intestinal samples were taken from animals in which SMA was ligated in order to achieve mesenteric ischemia and these samples were fi xed in 10 % formol. DISCUSSION: As a result, in rats with SMA occlusion serum D-dimer levels were not increased signifi cantly when compared either in the group or with the basal values of the control group and values in operative control group. Therefore, it is concluded that D-dimer is not a useful marker for early diagnosis of AMI. On the other hand, it is revealed that blood L-lactate levels began to increase signifi cantly following 4th hour of mesenteric ischemia and it is shown that this increase continued at the 6th hour. In addition, considering the utmost importance of the early diagnosis in patients with the clinical suspicion of AMI, L-lactate seems to be a suitable marker to use in emergency departments because it is achieved with a portable device that gives fast and accurate results. Nevertheless, our results are need to be supported by clinical studies with larger patient series (Tab. 2, Fig. 11, Ref. 39). Text in PDF www.elis.sk.

show abstract

“…These studies either do not include MVT or their proportion is too small [10,23], and one study has not done subgroup analysis based on aetiology which is the most important prognostic factor [3] as shown by the systematic review and many other studies. The present study analyses data after dividing patients with AMI into aetiological subgroups.…”

Section: Discussionmentioning

confidence: 99%

Acute Mesenteric Ischaemia—An Indian Perspective

et al. 2014

View full text Add to dashboard Cite

In Western countries, acute mesenteric ischaemia is commonly due to arterial occlusion and occurs in patients who are usually in their seventh decade. A venous cause for intestinal gangrene has been reported in only about 10 %. We examined whether this was so in India and compared the clinical features of patients with mesenteric arterial and venous ischaemia and relate these to their ultimate prognosis. We studied retrospectively, the records of all patients admitted or referred to the department with a diagnosis of acute mesenteric ischaemia between January 1997 and October 2012, noting their demographic details and mode of presentation, the results of preoperative imaging and blood investigations, the extent of bowel ischaemia, and the length of bowel that was resected at operation and their outcome. There were 117 patients, 85 males and 32 females whose median age was 53 years. Mesenteric venous thrombosis was seen in 56 patients (48 %) and mesenteric arterial occlusion in 61 (52 %). Forty six patients died (39 %); 15 with venous occlusion (27 %) and 31 with arterial occlusion (51 %). Compared to patients with arterial occlusion, the patients with venous obstruction were younger, had a longer duration of symptoms, were less frequently hypotensive at presentation, had higher platelet counts, had a shorter length of bowel resected, had fewer colonic resections and had a lower mortality. Other predictors of mortality on multivariate analysis were a longer duration of symptoms, lower serum albumin and higher creatinine levels at presentation and a shorter length of residual bowel. In India, acute mesenteric ischaemia in tertiary care centres is due to venous thrombosis in almost half of the patients who are at least a decade younger than those in the West. Significant predictors of mortality include low serum albumin and raised creatinine levels, a shorter residual bowel length and an arterial cause for mesenteric ischaemia.

show abstract

Determinants of mortality and treatment outcome following surgical interventions for acute mesenteric ischemia

Cited by 269 publications

References 30 publications

Diagnostic utility of the neutrophil-to-lymphocyte ratio in patients with acute mesenteric ischemia: A retrospective cohort study

Diagnostic utility of the neutrophil-to-lymphocyte ratio in patients with acute mesenteric ischemia: A retrospective cohort study

The place of D-dimer and L-lactate levels in the early diagnosis of acute mesenteric ischemia

Acute Mesenteric Ischaemia—An Indian Perspective

Contact Info

Product

Resources

About