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Multimodality Diagnosis of Mesenteric Ischemia
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Acute mesenteric ischemia following cardiovascular surgery--A nested case-control study.

H Mothes1, J Koeppen1, O Bayer2

  • 1Department of General, Visceral and Vascular Surgery, University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07740 Jena, Germany.

International Journal of Surgery (London, England)
|January 22, 2016
PubMed
Summary
This summary is machine-generated.

Acute mesenteric ischemia after cardiac surgery is rare but deadly. Identifying predictors like liver cirrhosis, emergency surgery, and specific post-op markers can aid early diagnosis and reduce mortality.

Keywords:
Acute mesenteric ischaemiaCardiovascular surgeryCase-control study

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Area of Science:

  • Cardiovascular Surgery
  • Gastroenterology
  • Critical Care Medicine

Background:

  • Acute mesenteric ischemia (AMI) is a rare but frequently fatal complication post-cardiac surgery.
  • Early detection of AMI is crucial for improving patient outcomes and reducing mortality.

Purpose of the Study:

  • To identify independent predictors and risk factors for the development of AMI following cardiovascular surgery.
  • To evaluate the prognostic accuracy of identified markers for early AMI diagnosis.

Main Methods:

  • Retrospective case-control study comparing patients with and without AMI post-cardiac surgery.
  • Univariate and logistic regression analyses were used to identify risk factors.
  • Receiver Operating Characteristic (ROC) curve analysis assessed prognostic accuracy.

Main Results:

  • 1.15% of 9385 patients developed AMI; in-hospital mortality was 68%.
  • Independent pre-operative predictors included liver cirrhosis and emergency operation.
  • Post-operative predictors included norepinephrine, epinephrine use, and serum lactate >3 mmol/L.
  • ROC analysis showed a prognostic accuracy (Area Under Curve) of 0.835.

Conclusions:

  • Early identification of pre- and post-operative predictors is vital for timely AMI diagnosis.
  • Key predictors include liver cirrhosis, emergency operation, serum lactate levels, and vasoactive medication use.
  • Prompt diagnosis and treatment of AMI post-cardiac surgery can significantly reduce mortality rates.