非闭塞性肠系膜缺血急诊手术后30天死亡率的危险因素
Risk Factors for 30-day Mortality After Emergency Surgery for Non-occlusive Mesenteric Ischemia.
作者信息
Minagawa Yume, Ishiyama Yasuhiro, Amiki Manabu, Hirano Yasumitsu
机构信息
Department of Gastroenterological Surgery, Kawasaki Saiwai Hospital, Kawasaki, Japan;
Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
出版信息
In Vivo. 2025 Sep-Oct;39(5):2893-2897. doi: 10.21873/invivo.14089.
BACKGROUND/AIM: Non-occlusive mesenteric ischemia (NOMI) is a rare and highly fatal disease characterized by intestinal ischemia or necrosis despite the absence of obstruction of the mesenteric vessels. This research aimed to investigate the risk factors for 30-day mortality of NOMI after emergency surgery.
PATIENTS AND METHODS
We analyzed 42 consecutive patients who underwent emergency surgery for NOMI from April 2015 to August 2022. Patients were divided into two groups, based on 30-day postoperative survival as follows: early death (30-day mortality group, n=9) and survival (survivor group, n=33). The characteristics, past history, and surgical outcomes were compared between the groups.
RESULTS
The 30-day mortality rate was 21.4%. There were no significant differences in the patients' characteristics and surgical complications between groups. However, the 30-day mortality group had a significantly higher number of patients with chronic kidney disease (CKD) (<0.01) and on hemodialysis (=0.01), as well as a significantly lower platelet count (=0.02). In the multivariate analysis, a preoperative lactate dehydrogenase >1,127 U/l was identified as an independent risk factor for 30-day mortality following emergency surgery for NOMI (odds ratio=23.6; 95% confidence interval=2.12-262.9; =0.01).
CONCLUSION
CKD, hemodialysis, high LDH, and low platelet count were found to be risk factors for early mortality from NOMI.
背景/目的：非闭塞性肠系膜缺血（NOMI）是一种罕见且致死率很高的疾病，其特征是尽管肠系膜血管没有阻塞，但肠道却出现缺血或坏死。本研究旨在调查急诊手术后NOMI患者30天死亡率的危险因素。
患者与方法
我们分析了2015年4月至2022年8月期间连续42例行NOMI急诊手术的患者。根据术后30天的生存情况将患者分为两组：早期死亡（30天死亡率组，n = 9）和存活（存活组，n = 33）。比较两组患者的特征、既往史和手术结果。
结果
30天死亡率为21.4%。两组患者的特征和手术并发症无显著差异。然而，30天死亡率组中慢性肾脏病（CKD）患者数量显著更多（<0.01），接受血液透析的患者数量显著更多（=0.01），血小板计数显著更低（=0.02）。在多变量分析中，术前乳酸脱氢酶>1127 U/l被确定为NOMI急诊手术后30天死亡率的独立危险因素（比值比=23.6；95%置信区间=2.12 - 262.9；=0.01）。
结论
CKD、血液透析、高乳酸脱氢酶和低血小板计数被发现是NOMI早期死亡的危险因素。
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