Service de Radiologie, CHU Besançon, F- 25030, Besançon, France; EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Franche-Comté, Besançon, France.
Service de Réanimation Médicale, CHU Besançon, F- 25030, Besançon, France.
Am J Surg. 2022 Jul;224(1 Pt B):617-623. doi: 10.1016/j.amjsurg.2022.03.048. Epub 2022 Apr 1.
The prognosis of critical ill patients with non-occlusive mesenteric ischemia (NOMI) is poor and not fully understood. We aimed to determine preoperative factors associated with 28-day mortality in NOMI.
Variables associated with 28-day mortality were entered into a multivariate cox regression model and were used to compute a NOMI mortality score.
154 patients were included. The 28-day mortality rate was 56%. Multivariable analyses including variables at the time of the CT identified three variables (i.e. lactates > 7 mmoL/l, prothrombin rate <60% and kidney infarction), included in a simple score. Among the study population, the probability of 28-day mortality was 26% (11/42), 54% (26/48), 77% (23/30) and 100% (21/21) for a survival score of 0, 1, 2 and 3, respectively.
A simple score combining these three variables, calculated preoperatively, was able to accurately predict 28-day mortality and might help to avoid futile laparotomies.
危重症非闭塞性肠系膜缺血（NOMI）患者的预后较差，目前尚不完全清楚。本研究旨在确定与 NOMI 28 天死亡率相关的术前因素。
将与 28 天死亡率相关的变量纳入多变量 Cox 回归模型，并用于计算 NOMI 死亡率评分。
共纳入 154 例患者，28 天死亡率为 56%。多变量分析包括 CT 时的变量，确定了 3 个变量（即乳酸>7 mmol/L、凝血酶原率<60%和肾梗死），纳入一个简单的评分中。在研究人群中，根据生存评分 0、1、2 和 3，28 天死亡率分别为 26%（11/42）、54%（26/48）、77%（23/30）和 100%（21/21）。
术前计算的、由这三个变量组成的简单评分能够准确预测 28 天死亡率，可能有助于避免无效剖腹手术。
