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Mortality Prediction Model before Surgery for Acute Mesenteric Infarction: A Population-Based Study.

Shang-Wei Lin1,2,3, Chung-Yen Chen1,3,4,5, Yu-Chieh Su3,6

  • 1Department of Surgery, E-Da Hospital, Kaohsiung 82445, Taiwan.

Journal of Clinical Medicine
|October 14, 2022
PubMed
Summary

A new scoring system, SAMIMS, predicts 30-day mortality for surgery in acute mesenteric infarction (AMI) patients. This tool stratifies risk, aiding clinical decision-making for AMI surgical outcomes.

Keywords:
acute mesenteric infarctionbowel resectionmortalitypreoperative risk factorsscoring systemsurgery

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Area of Science:

  • Surgical outcomes research
  • Clinical prediction modeling
  • Gastrointestinal surgery

Background:

  • Surgery for acute mesenteric infarction (AMI) carries a high mortality rate.
  • Effective risk stratification is crucial for managing AMI patients undergoing surgery.

Purpose of the Study:

  • To develop and validate a predictive model for 30-day mortality in patients undergoing surgery for AMI.
  • To create the ‘Surgery for acute mesenteric infarction mortality score’ (SAMIMS) system.

Main Methods:

  • Multivariable analysis was used to identify predictors of 30-day mortality.
  • Patients undergoing bowel resection for AMI were divided into derivation and validation groups.
  • The SAMIMS system incorporates factors such as age, hemodialysis, heart failure, peptic ulcer disease, diabetes, cerebrovascular disease, and liver disease.

Main Results:

  • The SAMIMS score effectively stratified patients into very low, low, intermediate, and high-risk groups for 30-day mortality.
  • Mortality rates increased significantly with higher risk scores in both derivation and validation cohorts.
  • The model demonstrated good discriminative ability with areas under the ROC curve of 0.677 and 0.696.

Conclusions:

  • The developed SAMIMS prediction model enables accurate stratification of 30-day mortality risk in surgical patients with AMI.
  • This tool can assist clinicians in identifying high-risk individuals and tailoring perioperative management.
  • The SAMIMS system offers a valuable approach to improving outcomes for acute mesenteric infarction surgery.