Factors Determining the Prognosis of Acute Mesenteric Ischemia

T. Kaya, Dilek Kuzukıran, S. Demirli Atıcı, I. Sert, Kenan Teker
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Abstract

Objective: Acute mesenteric ischemia (AMI) is a fatal vascular pathological condition requiring urgent surgical intervention, where early diagnosis significantly affects the prognosis. The aim of this study was to investigate the preoperative, perioperative and postoperative factors affecting mortality in patients who were operated with the diagnosis of AMI. Methods: Patients who were operated with the diagnosis of AMI between January 2012 and January 2016 were evaluated. The patients were grouped as survivors (group 1) and non-survivors (group 2). Age, gender, concomitant disease history, clinical and laboratory findings, surgical treatment, the remaining bowel amount, short bowel syndrome, ileocecal valve intactness, ostomy opening status, the first 30-day mortality and morbidities were recorded. Results: Among group 1 and group 2, respectively there was no statistically significant difference in terms of age, gender, concomitant disease, remaining bowel amount, short bowel syndrome, providing total parenteral nutrition support, ileocecal valve intactness and opening ostomy (p>0.05). Hemodialysis was found to be a risk factor for mortality (p=0.020). Conclusion: AMI is a disease with high mortality, and prognostic factors that can predict pre-op and postoperative mortality are still being investigated. While it is observed that ileocecal valve intactness does not affect mortality, the preoperative urea and creatinine elevation and the need for postoperative hemodialysis may be a predictors of mortality.
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决定急性肠系膜缺血预后的因素
目的:急性肠系膜缺血(AMI)是一种致命的血管病理疾病,需要紧急手术治疗,早期诊断对预后有重要影响。本研究的目的是探讨AMI手术患者术前、围术期和术后影响死亡率的因素。方法:回顾性分析2012年1月至2016年1月间因AMI手术的患者。将患者分为幸存者组(1组)和非幸存者组(2组)。记录患者的年龄、性别、合并病史、临床和实验室结果、手术治疗、剩余肠量、短肠综合征、回盲瓣完整性、造口状态、前30天死亡率和发病率。结果:1组与2组患者在年龄、性别、合并疾病、剩余肠量、短肠综合征、是否提供全肠外营养支持、回盲瓣完整性、开口等方面比较,差异均无统计学意义(p>0.05)。血液透析是死亡率的危险因素(p=0.020)。结论:AMI是一种高死亡率的疾病,能够预测术前和术后死亡率的预后因素仍在研究中。虽然观察到回盲瓣完整性不影响死亡率,但术前尿素和肌酐升高以及术后血液透析的需要可能是死亡率的预测因素。
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