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Title: Surgical outcomes in acute mesenteric ischemia: has anything changed over the years?
Authors: Acosta-Mérida, María Asunción 
Marchena-Gómez, Joaquín 
Saavedra-Santana, Pedro 
Silvestre-Rodríguez, José
Artiles-Armas, Manuel
Callejón-Cara, María Mar
UNESCO Clasification: 240401 Bioestadística
32 Ciencias médicas
Keywords: Mortality
Issue Date: 2020
Journal: World Journal of Surgery 
Abstract: Background: Despite increases in knowledge and advances in the management of acute mesenteric ischemia syndrome (AMI), there have been no significant improvements in mortality in recent years. The objective of this study was to assess the changes in clinical characteristics and surgical outcomes in patients who underwent AMI over time. Methods: A total of 323 consecutive patients who underwent acute mesenteric ischemia at our institution between 1990 and 2015 were examined. The occurrence of significant changes over this 25-year period in demographic data, comorbidity, clinical characteristics, laboratory results, operative findings, etiology of the AMI, and operative mortality were evaluated. The evolution mortality rates for the studied period were analyzed using the additive logistic regression, and the significant effect was determined using the Akaike Information Criterion (AIC). Results: A significant increasing linear trend was observed in recent years in Charlson score values (p = 0.008), antiplatelet drug intake (p < 0.001), use of CT scan (p < 0.001), arterial thrombosis (p < 0.001), and intestinal resection (p = 0.047), while a decreasing linear trend was observed in digoxin intake (p < 0.001), angiography use (p = 0.004), and embolia (p < 0.001). The rest of the parameters did not present changes over time. Regarding the evolution of the adjusted surgical mortality, a significant decrease according the AIC criterion was observed. Conclusions: In recent years, the characteristics of patients with AMI requiring surgery have changed. Changes in operative mortality have also been detected, showing a tendency toward a progressive and significant decrease.
ISSN: 0364-2313
DOI: 10.1007/s00268-019-05183-9
Source: World Journal of Surgery [ISSN 0364-2313], v. 44 (1), p. 100-107
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