The effect of comorbidity on early clinical decision making in acute mesenteric ischemia

Parys, Simon; Daneshmand, Ali; Sieunarine, Kishore; Watanabe, Yuki

doi:10.1080/00015458.2021.1916281

Cited by 6 publications

(2 citation statements)

References 20 publications

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“…Для оценки влияния сопутствующих заболеваний на общее состояние и для прогнозирования исхода чаще всего используют модифицированный индекс коморбидности Чарлсона -Charlson Comorbidity Index (CCI) [7][8][9]. Тем не менее как для предиктора исхода ОМИ у данного индекса однозначных результатов не получено [10].…”

Section: Introductionunclassified

Acute non-occlusive mesenteric ischemia in patients with various types of comorbidities and postoperative complications: clinical case and observation.

Rogal,

Lebedev,

Yartsev

et al. 2023

jour

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Aim. To enhance the outcomes of treating patients with acute non-occlusive mesenteric ischemia (focal) following colostomy, aiming to gain a better understanding of the prevalent risk factors for complications and exploring ways of their reduction.Materials and methods. A clinical case detailing the treatment of a patient with acute non-occlusive mesenteric ischemia amidst abdominal sepsis and stoma necrosis, compounded by inflammatory disease of the spinal cord membranes, is presented. Additionally, the clinical observation of a patient experiencing postoperative complications, including coronavirus infection and bilateral hydrothorax, is provided.Results. In a patient presenting severe coronary pathology alongside a nuanced clinical manifestation of mesenteric ischemia in the delayed phase, a surgical intervention involving intestinal tract resection and subsequent stoma removal was conducted. Regrettably, stoma necrosis ensued, necessitating reconstructive surgery. The patient’s initial critical state, compounded by the requirement for repeated surgical intervention, precipitated a swift progression of multiple organ failure, culminating in mortality. Conversely, another patient, postoperatively diagnosed with coronavirus infection and bilateral hydrothorax, exhibited amelioration in clinical status following administered treatment, ultimately warranting hospital discharge.Conclusions. Early diagnosis and timely surgical intervention contribute to improving the prognosis of treatment. Early postoperative complications and repeated surgical interventions significantly worsen the prognosis.

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Section: Introductionunclassified

Acute non-occlusive mesenteric ischemia in patients with various types of comorbidities and postoperative complications: clinical case and observation.

Rogal,

Lebedev,

Yartsev

et al. 2023

jour

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“…As such, the Charlson comorbidity index (CCI) was introduced to assess the role of comorbidities for overall prognosis [15] and is nowadays also used to predict outcome after surgery [16,17]. Few studies have investigated the CCI as predictor of outcome for AMI with divergent results [18,19].…”

Section: Introductionmentioning

confidence: 99%

Acute Mesenteric Ischemia: Preexisting Comorbidity Determines Short-Term Outcome and Quality of Life in Long-Term Survivors

et al. 2022

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Introduction: Acute mesenteric ischemia (AMI), either arterial or venous, is still a devastating disease with poor prognosis. It is unknown, whether AMI is associated with impaired quality of life (QoL) in long-term survivors. Material and Methods: This retrospective analysis includes 64 patients with occlusive arterial or venous mesenteric ischemia treated operatively between 2008 and 2016 at the University Medical Center Rostock. Short-term outcome with focus on comorbidities was measured by the Charlson comorbidity index (CCI) an instrument that operationally measures comorbidity based on 17 clinical parameters including age. Operative outcome in view of enterostomy placement and long-term outcome measured as QoL by the EQ-5D in the long-term survivors were evaluated. The EQ-5D is a standardized, self-reported five-dimension QoL questionnaire built to provide a simple and generic measure of health. Results: Thirty-day mortality was 60.9%, and in-hospital mortality was 70.3% (n = 45). No patient was discharged with a stoma. Patients with a primary anastomosis after the initial operation for AMI had a high leak rate of 27% (4/15 patients) compared to no dehiscence in the group of patients who had secondary anastomosis during second or third laparotomy. The long-term survivors had significantly lower CCI compared to the 45 nonsurvivors (median 4 [3, 4, 5, 6] vs. 6 [4, 5, 6, 7]). All long-term survivors had QoL assessment. QoL score was significantly impaired compared to an age- and sex-matched reference population. This impairment was not due to disease-specific sequelae such as presence of stool deviation or intestinal failure but due to preexisting risk factors as shown by an inverse relation between the CCI and QoL score. Conclusion: Herein, we show for the first time that long-term QoL in patients with AMI is impaired but this impairment is not due to disease-specific aspects but rather general risk factors underlying the presence of a higher level of comorbidities at the time of AMI.

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Bowel Ischemia

Pata,

Pellino

et al. 2023

Hot Topics in Acute Care Surgery and Trauma

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The effect of comorbidity on early clinical decision making in acute mesenteric ischemia

Cited by 6 publications

References 20 publications

Acute non-occlusive mesenteric ischemia in patients with various types of comorbidities and postoperative complications: clinical case and observation.

Acute non-occlusive mesenteric ischemia in patients with various types of comorbidities and postoperative complications: clinical case and observation.

Acute Mesenteric Ischemia: Preexisting Comorbidity Determines Short-Term Outcome and Quality of Life in Long-Term Survivors

Bowel Ischemia

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