He Qi-Na, Chen Lang, Hu Han-Yu, Yang Zhe, Huang Jing-Yong, Miao Shou-Liang, Chen Fan-Feng
The First Clinical Medical College, Wenzhou Medical University, Wenzhou, China.
The Second Clinical Medical College, Wenzhou Medical University, Wenzhou, China.
Vascular. 2024 Oct;32(5):1026-1035. doi: 10.1177/17085381231164663. Epub 2023 Mar 22.
Acute mesenteric ischemia (AMI) is a life-threatening surgical emergency with a poor prognosis. This study assessed the association of diffuse reduction of spleen density (DROSD) with postoperative complications and identified risk factors for adverse outcomes in AMI patients after surgery.
Patients who were diagnosed with AMI and underwent surgical operations between April 2006 and July 2021 were enrolled. Spleen density was assessed using preoperative non-enhanced computed tomography. The lowest quartile of spleen density in all patients was regarded as the cutoff value for DROSD. Univariate and multivariate analyses were performed to determine the risk factors related to postoperative outcomes after surgery.
According to the diagnostic cutoff, patients with a spleen density ≤49.07 HU were defined as DROSD. In a cohort of 97 patients, 34.0% developed complications within 30 days of surgery. The multivariate analysis illustrated that DROSD was an independent risk factor for prognostic outcomes in AMI patients after surgery.
Patients with low spleen density were prone to postoperative complications. As an imaging method, preoperative assessment of spleen density is a novel predictor that can be used clinically to identify high-risk AMI patients with poor prognosis.
急性肠系膜缺血(AMI)是一种危及生命的外科急症,预后较差。本研究评估了脾脏密度弥漫性降低(DROSD)与术后并发症的相关性,并确定了AMI患者术后不良结局的危险因素。
纳入2006年4月至2021年7月期间诊断为AMI并接受手术的患者。术前采用非增强计算机断层扫描评估脾脏密度。将所有患者脾脏密度的最低四分位数作为DROSD的临界值。进行单因素和多因素分析以确定与术后结局相关的危险因素。
根据诊断临界值,脾脏密度≤49.07 HU的患者被定义为DROSD。在97例患者队列中,34.0%的患者在术后30天内出现并发症。多因素分析表明,DROSD是AMI患者术后预后结局的独立危险因素。
脾脏密度低的患者易发生术后并发症。作为一种影像学方法,术前评估脾脏密度是一种新型预测指标,可在临床上用于识别预后不良的高危AMI患者。