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Predictive Risk Factors of Intestinal Necrosis in Patients with Mesenteric Venous Thrombosis: Retrospective Study

Yong Wang1, Rui Zhao1, Lin Xia1

  • 1Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.

Canadian Journal of Gastroenterology & Hepatology
|June 18, 2019
PubMed
Abstract

Insights

Mesenteric venous thrombosis (MVT) can lead to intestinal necrosis (IN). Key predictors for IN in MVT patients include organ failure, high lactate levels, bowel dilation on CT scans, and delayed surgery.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Radiology

Background:

  • Mesenteric venous thrombosis (MVT) is a critical condition with significant morbidity and mortality.
  • Early identification of risk factors for intestinal necrosis (IN) in MVT patients is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To identify independent risk factors associated with the development of intestinal necrosis (IN) in patients diagnosed with mesenteric venous thrombosis (MVT).
  • To develop a predictive model for IN in MVT patients.

Main Methods:

  • A retrospective review of patients diagnosed with MVT between 2014 and May 2018.
  • Assessment of patient characteristics and risk factors for IN, including clinical data and imaging findings.
  • Multivariate analysis was performed to identify significant predictors of IN.

Main Results:

  • Of 78 MVT patients, 58 (74%) developed IN.
  • Independent predictors for IN included organ failure (OR: 4.1), elevated serum lactate (OR: 3.6), bowel loop dilation on CT (OR: 2.8), and time from symptom onset to operation (OR: 4.8).
  • The predictive model demonstrated high diagnostic accuracy (AUC = 0.901).

Conclusions:

  • Organ failure, elevated serum lactate, bowel loop dilation on CT, and delayed surgical intervention are significant predictive risk factors for IN in MVT patients.
  • These findings can aid in the early prediction and management of IN in MVT.
  • Further large-scale prospective studies are warranted to validate these predictive factors.

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