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Digestion. 2009;80(2):104-11. doi: 10.1159/000219367. Epub 2009 Jun 26.

New prediction rule for mortality in acute mesenteric ischemia.

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  • 1Department of Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan. epass2006@yahoo.co.jp

Abstract

OBJECTIVE:

Acute mesenteric ischemia is potentially fatal, but prognostic factors have not yet been established. This study was undertaken to elucidate them.

METHODS:

This is a retrospective cohort study, consisting of 110 patients who had been treated in the past 5 years, from 26 national hospitals in Japan.

RESULTS:

The overall in-hospital mortality rate was 51%. Logistic regression analysis demonstrated two independent prognostic factors, electrocardiogram scale with an odds ratio of 1.7 (95% CI 1.2-2.4) and shock index of 11 (95% CI 1.5-80). A stepwise analysis gave a prediction equation for in-hospital mortality (R) using these variables and age score. We further modified this equation to a simpler scoring system (S) using the same variables. Both R and S showed a good discriminatory ability as determined by areas under the receiver-operating characteristic curve (0.83, 95% CI: 0.74-0.91 for R; 0.82, 95% CI 0.74-0.91 for S). The observed mortality rates increased as the R or S increased (19% at R <0.25, 41% at 0.25 < or = R <0.6, 85% at R > or =0.6; 19% at S < or =2, 37% at S of 3 or 4, 91% at S > or =5).

CONCLUSION:

The new prediction rules can be used at any hospital and may be promising tools for medical decision-making, informed consent and reviewing quality of care.

Copyright 2009 S. Karger AG, Basel.

PMID:
19556795
[PubMed - indexed for MEDLINE]
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