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Clinical Outcomes and Prognostic Factors After Surgery for Non-Occlusive Mesenteric Ischemia: a Multicenter Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

To date, no large-scale study has been undertaken to understand the clinical features of non-occlusive mesenteric ischemia (NOMI) after surgery. We thus performed a multicenter investigation to clarify the clinical outcomes and prognostic factors of NOMI.

Patients and Methods

Clinical databases from 22 Japanese facilities were reviewed for evaluation of patients who received surgery for NOMI between 2004 and 2012. NOMI patients (n = 51) were divided into two groups: group I (n = 28) consisted of patients who survived, and group II (n = 23) consisted of patients who did not survived. Prognostic factors were compared between the two groups.

Results

NOMI surgery represented 0.04 % of the total number of operations performed in this time period. The overall mortality rate for NOMI surgery was 45 %. Hemodialysis was a significant negative prognostic factor (p = 0.027). Preoperative elevation of transaminases, potassium, and white blood cell count, as well as metabolic acidosis and colon ischemia was poor prognostic factors. The mean Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) score of group I versus group II was 54.5 ± 3.6 and 85.2 ± 4.1, respectively (p < 0.001).

Conclusions

Currently, NOMI surgery has a 45 % mortality rate. POSSUM scores can be used to predict the clinical outcome of patients who receive NOMI surgery.

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Acknowledgments

We wish to thank the following institutions for participating in the investigation: Iizuka Hospital, Imari Arita Kyoritsu Hospital, Eikou Hospital, Oita Medical Center, Oita Prefecture Hospital, Oita Red Cross Hospital, Onga Hospital, Kitakyushu Municipal Medical Center, Kakizoe Hospital, National Kyushu Cancer Center, Saiseikai Karatsu Hospital, Saiseikai Fukuoka General Hospital, Saiseikai Yahata General Hospital, Shinnakama Hospital, Nakatsu Municipal Hospital, Hita Central Hospital, Hiroshima Red Cross Hospital & Atomic Bomb Survivors Hospital, Fukuoka City Hospital, National Fukuoka-Higashi Medical Center, Steel Memorial Yawata Hospital, Beppu Medical Center, Matsuyama Red Cross Hospital, and Munakata Medical Association Hospital.

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan

    Takafumi Yukaya, Hiroshi Saeki, Kenji Taketani, Koji Ando, Satoshi Ida, Yasue Kimura, Eiji Oki, Mitsuhiro Yasuda, Masaru Morita, Ken Shirabe & Yoshihiko Maehara

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  1. Takafumi Yukaya
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  2. Hiroshi Saeki
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  3. Kenji Taketani
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  4. Koji Ando
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  5. Satoshi Ida
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  6. Yasue Kimura
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  7. Eiji Oki
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  8. Mitsuhiro Yasuda
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  9. Masaru Morita
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  10. Ken Shirabe
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  11. Yoshihiko Maehara
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Correspondence to Takafumi Yukaya.

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Yukaya, T., Saeki, H., Taketani, K. et al. Clinical Outcomes and Prognostic Factors After Surgery for Non-Occlusive Mesenteric Ischemia: a Multicenter Study. J Gastrointest Surg 18, 1642–1647 (2014). https://doi.org/10.1007/s11605-014-2579-0

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  • DOI: https://doi.org/10.1007/s11605-014-2579-0

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