Outcome after surgery for acute right-sided colonic ischemia without feasible vascular intervention: a single center experience of 58 patients over 6 years

Käser, Samuel; Müller, Tara C; Guggemos, A.; Nitsche, Ulrich; Späth, Christoph; Maurer, Christoph A.; Janssen, Klaus–Peter; Kleeff, Jörg; Frieß, Helmut; Wilhelm, Dirk; Bader, Franz G.

doi:10.1186/s12893-015-0018-0

Cited by 13 publications

(7 citation statements)

References 20 publications

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“…Another investigation identified 58 patients with right sided colonic gangrene and concluded that in this subgroup 54% had some degree of mesenteric atherosclerosis present on radiological examination. 219 In one study focusing on fatal isolated colonic ischaemia identified at autopsy, 53 patients were identified. 220 In this study the left colon was most commonly affected, but the caecum was affected in 25%, and the ascending colon in 26%.…”

Section: The Role Of Imagingmentioning

confidence: 99%

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Björck¹,

Koelemay²,

Acosta³

et al. 2017

European Journal of Vascular and Endovascular Surgery

501

226

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She participated very actively in the process of developing these guidelines, in particular the important chapters on chronic arterial and venous mesenteric ischaemia. Six days after the second meeting of the task force she died unexpectedly, to our great despair and loss. We honour her dedication and scientific integrity by completing these guidelines. Among many other commitments she was a very productive reviewer and an associate editor of this journal. You can read more about Paola's important contributions to science and to the vascular community in the April 2016 issue of the European Journal of Vascular and Endovascular Surgery. 1

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Section: The Role Of Imagingmentioning

confidence: 99%

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Björck¹,

Koelemay²,

Acosta³

et al. 2017

European Journal of Vascular and Endovascular Surgery

501

226

View full text Add to dashboard Cite

show abstract

“…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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“…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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Outcome after surgery for acute right-sided colonic ischemia without feasible vascular intervention: a single center experience of 58 patients over 6 years

Cited by 13 publications

References 20 publications

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

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

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