Prognostic factors of acute mesenteric ischemia in ICU patients.

BMC Gastroenterol 2019 May 30;19(1):80. Epub 2019 May 30.

Department of Intensive Care, Cliniques St-Luc, Université catholique de Louvain, Avenue Hippocrate, 10, 1200, Brussels, Belgium.

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.

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12876-019-0999-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543602PMC
May 2019
8 Reads

Publication Analysis

Top Keywords

mesenteric ischemia
12
icu patients
8
factors acute
8
acute mesenteric
8
prognostic factors
8
mortality rate
8
patients
5
diagnostic procedures
4
investigations diagnostic
4
laboratory investigations
4
admission laboratory
4
surgery three
4
therapy severity
4
severity scores
4
subgroup aortic
4
three factors
4
procedures therapy
4
aortic surgery
4
factors associated
4
stay prior
4

References

(Supplied by CrossRef)
Article in Best Pract Res Clin Gastroenterol
JM Kärkkäinen et al.
Best Pract Res Clin Gastroenterol 2017
Article in N Engl J Med
DG Clair et al.
N Engl J Med 2016
Article in Langenbeck's Arch Surg
WT Kassahun et al.
Langenbeck's Arch Surg 2008
Article in Br J Surg
IG Schoots et al.
Br J Surg 2004
Article in Semin Vasc Surg
S Acosta et al.
Semin Vasc Surg 2010
Article in Acad Emerg Med
MT Cudnik et al.
Acad Emerg Med 2013
Article in Radiology
J Menke et al.
Radiology 2010
Article in Intensive Care Med
M Leone et al.
Intensive Care Med 2015
Article in Intensive Care Med
JL Vincent et al.
Intensive Care Med 1996
Article in Crit Care Med
WA Knaus et al.
Crit Care Med 1985
Article in JAMA
M Singer et al.
JAMA 2016

Similar Publications