Monitoring the Sequential Organ Failure Assessment score in nonocclusive mesenteric ischemia increases the survival rate: A single-center observational study

• Published in: Medicine (Baltimore) Vol. 100; no. 48; p. e28056
• Main Authors: Murata, Takaaki, Kawachi, Jun, Igarashi, Yuto, Suno, Yuma, Nishida, Tomoki, Miyake, Katsunori, Isogai, Naoko, Fukai, Ryuta, Kashiwagi, Hiroyuki, Shimoyama, Rai, Hirata, Masahiro, Shinozaki, Nobuaki
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 03.12.2021
• Subjects: Aged; Aged, 80 and over; Female; Hospital Mortality; Humans; Male; Mesenteric Ischemia - diagnosis; Mesenteric Ischemia - mortality; Mesenteric Ischemia - surgery; Observational Study; Organ Dysfunction Scores; Prognosis; Retrospective Studies; Survival Rate
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000028056

Several large-scale studies have assessed the endovascular and surgical treatments for nonocclusive mesenteric ischemia (NOMI); nonetheless, the prognostic factors for NOMI remain unclear.In this single-center study, we retrospectively reviewed the electronic medical records of 197, 149 patients were retrieved from the inpatient database of our hospital from January 2011 to January 2020; 79 patients with NOMI were observed. A total of 44 patients who underwent laparotomy were statistically analyzed and divided into the survivor and non-survivor groups. Prognostic factors were compared between the 2 groups. Exploratory laparotomy based on a second-look surgery was the first treatment choice.The overall mortality rate was 61.3%, with a male-to-female ratio of 1.6:1. The median Sequential Organ Failure Assessment (SOFA) score was 11.06 [5.75-17.25]. The median SOFA score was 5 [interquartile range: 3-8] in the survivor group and 14.8 [interquartile range: 10.5-19] in the non-survivor group. The log-rank test showed a significant difference in the presence of diabetes mellitus (P = .025), hypoglycemia (P = .001), SOFA score ≥10 (P < .001), hemoglobin levels ≥11 g/dL (P = .003), platelet count ≥12.9 × 104/μL (P = .01), lactate levels ≥2.6 mmol/L (P = .005), and base excess <-3.0 (P < .023). Multivariate analysis using the factors with significant differences revealed that SOFA score ≥10 (hazard ratio for death, 1.199; 95% confidence interval, 1.101-1.305; P < .001) was an independent prognostic factor.The SOFA score can be used to assess disease severity. A SOFA score of ≥10 may be associated with increased mortality.