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Qiu YH, Zhang YH, Wu ZC, Yang Z, Zhu GX, Miao SL, Chen BC, Chen FF. Outcomes after open and endovascular treatment for mesenteric artery embolism patients: a retrospective inverse probability of treatment-weighted analysis. Eur J Trauma Emerg Surg 2024; 50:2883-2893. [PMID: 39190060 DOI: 10.1007/s00068-024-02647-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Accepted: 08/13/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE This study aims to evaluate outcomes in patients with mesenteric artery embolism (MAE) who received primary endovascular therapy (EVT) or laparotomy, and investigate risk factors for 30-day mortality. METHODS A retrospective analysis of 94 MAE patients who underwent two different treatment strategies was undertaken. An inverse probability of treatment weighting (IPTW) method was used to balance the confounding effects of baseline clinical data. Logistic regression analysis was performed to compare the outcomes according to type of treatment regimens before and after IPTW. Univariate and multivariable analysis were conducted to determine the risk factors for 30-day mortality. RESULTS Twenty-eight MAE patients received primary EVT, and 66 Open Surgery (OS). Logistic regression analysis showed that there was no significant difference between the EVT and OS group in 30-day mortality rate before (odds ratio [OR] 0.477, 95% confidence interval [CI] 0.170 to 1.340, P = 0.160), and after IPTW (OR 0.647, 95% CI 0.210 to 1.993, P = 0.449). After IPTW, it revealed that the rates of second-look surgery (OR 36.727, 95% CI 5.407 to 249.458, P < 0.001) and hospital stay [> 30 days] (OR 0.006, 95% CI 0.000 to 0.363, P = 0.014) were different in the two groups. D-dimer (> 4 mg/L) and procalcitonin (> 0.5 ng/mL) were the independent risk factors for 30-day mortality in MAE patients postoperatively (P < 0.05). CONCLUSION In this retrospective study, MAE patients who performed primary EVT had no obvious difference in 30-day mortality rate compared to those who received OS; but it was conducive to reducing prolonged hospital stays. An increase in procalcitonin level and higher D-dimer were associated with short-term poor prognosis in patients with MAE.
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Affiliation(s)
- Yi-Hui Qiu
- Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Nanbaixiang, Wenzhou, 325015, Zhejiang, P.R. China
| | - Yin-He Zhang
- Molecular Pharmacology Research Center, School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, 325000, China
| | - Zi-Chang Wu
- Molecular Pharmacology Research Center, School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, 325000, China
| | - Zhe Yang
- The Second Clinical Medical College, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China
| | - Guan-Xia Zhu
- Department of Radiology, Longgang People's Hospital, Wenzhou, 325802, China
| | - Shou-Liang Miao
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015, China
| | - Bi-Cheng Chen
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015, China.
| | - Fan-Feng Chen
- Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Nanbaixiang, Wenzhou, 325015, Zhejiang, P.R. China.
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Mihaileanu FV, Popa SL, Grad S, Dumitrascu DI, Ismaiel A, Rus E, Brata VD, Padureanu AM, Dita MO, Turtoi DC, Duse TA, Badulescu AV, Bottalico P, Chiarioni G, Pop C, Mogosan C, Barsan M, Gherman CD, Stancu B, David L. The Efficiency of Serum Biomarkers in Predicting the Clinical Outcome of Patients with Mesenteric Ischemia during Follow-Up: A Systematic Review. Diagnostics (Basel) 2024; 14:670. [PMID: 38611583 PMCID: PMC11011801 DOI: 10.3390/diagnostics14070670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
The initial clinical manifestation of acute mesenteric ischemia poses a diagnostic challenge, often leading to delays in identification and subsequent surgical intervention, contributing to adverse outcomes. Serum biomarkers, offering insights into the underlying pathophysiology, hold promise as prognostic indicators for acute mesenteric ischemia. This systematic review comprehensively explores the role of blood biomarkers in predicting clinical outcomes during follow-up for patients with mesenteric ischemia. A thorough literature search across the PubMed, Cochrane Library, and EMBASE databases yielded 33 relevant publications investigating the efficacy of serum biomarkers in predicting outcomes for mesenteric ischemia. Numerous studies underscore the utility of blood biomarkers in swiftly and accurately differentiating between causes of mesenteric ischemia, facilitating a prompt diagnosis. Elevated levels of specific biomarkers, particularly D-dimers, consistently correlate with heightened mortality risk and poorer clinical outcomes. While certain serum indicators exhibit substantial potential in associating with mesenteric ischemia, further research through rigorous human trials is imperative to enhance their consistent predictive ability during the follow-up period. This study underscores the diagnostic and prognostic significance of specific biomarkers for mesenteric ischemia, emphasizing the necessity for standardized procedures in future investigations.
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Affiliation(s)
- Florin Vasile Mihaileanu
- Department of Surgery, County Hospital, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (F.V.M.); (B.S.)
| | - Stefan Lucian Popa
- 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (S.G.); (A.I.); (L.D.)
| | - Simona Grad
- 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (S.G.); (A.I.); (L.D.)
| | - Dinu Iuliu Dumitrascu
- Department of Anatomy, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Abdulrahman Ismaiel
- 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (S.G.); (A.I.); (L.D.)
| | - Eliza Rus
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Vlad Dumitru Brata
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Alexandru Marius Padureanu
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Miruna Oana Dita
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Daria Claudia Turtoi
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Traian Adrian Duse
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Andrei Vlad Badulescu
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Paolo Bottalico
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy;
| | - Giuseppe Chiarioni
- Division of Gastroenterology B, AOUI Verona, University of Verona, 37126 Verona, Italy;
| | - Cristina Pop
- Department of Pharmacology, Physiology, and Pathophysiology, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (C.P.); (C.M.)
| | - Cristina Mogosan
- Department of Pharmacology, Physiology, and Pathophysiology, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (C.P.); (C.M.)
| | - Maria Barsan
- Department of Occupational Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Claudia Diana Gherman
- Department of Surgery-Practical Abilities, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400337 Cluj-Napoca, Romania;
| | - Bogdan Stancu
- Department of Surgery, County Hospital, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (F.V.M.); (B.S.)
| | - Liliana David
- 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (S.G.); (A.I.); (L.D.)
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