Ohira Gaku, Hayano Koichi, Tochigi Toru, Maruyama Tetsuro, Toyozumi Takeshi, Kurata Yoshihiro, Maruyama Michihiro, Arai Satoko, Nakada Taka-Aki, Matsubara Hisahiro
Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuuou-Ku, Chiba, 260-8670, Japan.
Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuuou-Ku, Chiba, 260-8670, Japan.
Surg Today. 2025 Mar;55(3):360-369. doi: 10.1007/s00595-024-02909-8. Epub 2024 Aug 1.
To investigate the treatment outcomes of patients with non-occlusive mesenteric ischemia (NOMI) at our institution, we focused on their post-treatment return to social activities.
This study included patients with suspected NOMI who were referred to our department between 2011 and 2023. In-hospital mortality was also investigated as a prognostic factor. The Glasgow-Pittsburgh Outcome Categories (GPOC) score was used to evaluate the return to social activities. The relationship between in-hospital mortality and GPOC scores and patient background and treatment factors was examined.
Eighty-two patients were included in the study. Among them, 54 (65.9%) died during hospitalization. Only 9 patients (11%) returned to their social activities. In the multivariate analysis, non-surgical management was found to be the only independent factor for in-hospital mortality. Positive portal venous gas on computed tomography, no open abdomen, no pre-onset catecholamine administration, platelet count < 100,000/µL, lactate level < 5 mmol/L, APTT < 46 s, and Sequential Organ Failure Assessment score < 11 were factors significantly associated with an increased likelihood of return to social activities.
This is the first study to assess the post-treatment return to social activities among patients with NOMI. Our findings highlight the concerning reality that survivors may face prolonged dependence on medical care.
为了调查我院非闭塞性肠系膜缺血（NOMI）患者的治疗结果，我们重点关注了他们治疗后恢复社会活动的情况。
本研究纳入了2011年至2023年间转诊至我科的疑似NOMI患者。还将住院死亡率作为一个预后因素进行了调查。采用格拉斯哥-匹兹堡预后分类（GPOC）评分来评估恢复社会活动的情况。研究了住院死亡率与GPOC评分、患者背景及治疗因素之间的关系。
82例患者纳入研究。其中，54例（65.9%）在住院期间死亡。只有9例患者（11%）恢复了社会活动。在多因素分析中，非手术治疗被发现是住院死亡率的唯一独立因素。计算机断层扫描显示门静脉积气阳性、未行开腹手术、发病前未使用儿茶酚胺、血小板计数<100,000/µL、乳酸水平<5 mmol/L、活化部分凝血活酶时间<46 s以及序贯器官衰竭评估评分<11是与恢复社会活动可能性增加显著相关的因素。
这是第一项评估NOMI患者治疗后恢复社会活动情况的研究。我们的研究结果凸显了幸存者可能面临长期依赖医疗护理这一令人担忧的现实。
