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Prognostic factors of acute mesenteric ischemia in ICU patients
BACKGROUND: The primary endpoint was to investigate the prognostic factors of acute mesenteric ischemia (AMI) in ICU patients. METHODS: Retrospective observational, non-interventional, monocentric study of a cohort of 214 ICU patients with a confirmed diagnosis of arterial AMI. RESULTS: We collected...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543602/ https://www.ncbi.nlm.nih.gov/pubmed/31146693 http://dx.doi.org/10.1186/s12876-019-0999-8 |
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author | Caluwaerts, Martin Castanares-Zapatero, Diego Laterre, Pierre-François Hantson, Philippe |
author_facet | Caluwaerts, Martin Castanares-Zapatero, Diego Laterre, Pierre-François Hantson, Philippe |
author_sort | Caluwaerts, Martin |
collection | PubMed |
description | BACKGROUND: The primary endpoint was to investigate the prognostic factors of acute mesenteric ischemia (AMI) in ICU patients. METHODS: Retrospective observational, non-interventional, monocentric study of a cohort of 214 ICU patients with a confirmed diagnosis of arterial AMI. RESULTS: We collected demographics, mortality, hospital stay, prior medical history, comorbidities, reasons for ICU admission, laboratory investigations, diagnostic procedures, therapy, severity scores. The 30-day mortality rate was 71% for the 214 patients with arterial AMI. The incidence of nonocclusive mesenteric ischemia was particularly high. AMI was a secondary diagnosis in 58% of patients. Half of the population was represented by surgical patients who mostly required an urgent procedure. The mortality rate was not different in the subgroup with aortic surgery. Three factors were associated with an increase or decrease in mortality: the maximal dose of vasopressors (VP) administered to the patient (OR = 1.20; 95%CI = 1.08–1.33; p < 0.001), arterial change in lactate values within the first 24 h of admission (OR = 1.24; 95%CI = 1.05–1.48; p = 0.012) and anticoagulation (OR = 0.19; 95%CI = 0.043–0.84; p = 0.029). CONCLUSIONS: Fatalities after AMI were related to a high incidence of multi-organ failure. The monitoring of arterial lactate appeared helpful to identify the patients with a poor prognosis. |
format | Online Article Text |
id | pubmed-6543602 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65436022019-06-04 Prognostic factors of acute mesenteric ischemia in ICU patients Caluwaerts, Martin Castanares-Zapatero, Diego Laterre, Pierre-François Hantson, Philippe BMC Gastroenterol Research Article BACKGROUND: The primary endpoint was to investigate the prognostic factors of acute mesenteric ischemia (AMI) in ICU patients. METHODS: Retrospective observational, non-interventional, monocentric study of a cohort of 214 ICU patients with a confirmed diagnosis of arterial AMI. RESULTS: We collected demographics, mortality, hospital stay, prior medical history, comorbidities, reasons for ICU admission, laboratory investigations, diagnostic procedures, therapy, severity scores. The 30-day mortality rate was 71% for the 214 patients with arterial AMI. The incidence of nonocclusive mesenteric ischemia was particularly high. AMI was a secondary diagnosis in 58% of patients. Half of the population was represented by surgical patients who mostly required an urgent procedure. The mortality rate was not different in the subgroup with aortic surgery. Three factors were associated with an increase or decrease in mortality: the maximal dose of vasopressors (VP) administered to the patient (OR = 1.20; 95%CI = 1.08–1.33; p < 0.001), arterial change in lactate values within the first 24 h of admission (OR = 1.24; 95%CI = 1.05–1.48; p = 0.012) and anticoagulation (OR = 0.19; 95%CI = 0.043–0.84; p = 0.029). CONCLUSIONS: Fatalities after AMI were related to a high incidence of multi-organ failure. The monitoring of arterial lactate appeared helpful to identify the patients with a poor prognosis. BioMed Central 2019-05-30 /pmc/articles/PMC6543602/ /pubmed/31146693 http://dx.doi.org/10.1186/s12876-019-0999-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Caluwaerts, Martin Castanares-Zapatero, Diego Laterre, Pierre-François Hantson, Philippe Prognostic factors of acute mesenteric ischemia in ICU patients |
title | Prognostic factors of acute mesenteric ischemia in ICU patients |
title_full | Prognostic factors of acute mesenteric ischemia in ICU patients |
title_fullStr | Prognostic factors of acute mesenteric ischemia in ICU patients |
title_full_unstemmed | Prognostic factors of acute mesenteric ischemia in ICU patients |
title_short | Prognostic factors of acute mesenteric ischemia in ICU patients |
title_sort | prognostic factors of acute mesenteric ischemia in icu patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543602/ https://www.ncbi.nlm.nih.gov/pubmed/31146693 http://dx.doi.org/10.1186/s12876-019-0999-8 |
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