What affects the prognosis of NOMI patients? Analysis of clinical data and CT findings
Abstract
Background Non-occlusive mesenteric ischemia (NOMI) is a mesenteric ischemic disease with considerably high mortality rate, although little has been known about what factors affect the patients' prognosis. The purpose of this study was to investigate prognostic factors of clinical data and computed tomography (CT) findings in patients with NOMI.Methods This was a single institutional, retrospective study, reviewing 21 consecutive patients diagnosed with NOMI on angiography. Patients were divided into either ''survivor'' group or ''non-survivor'' group based on their clinical courses 1 month after diagnosis. Clinical information such as laboratory data, Charlson Comorbidity Index, and time from CT to injecting vasodilator was obtained from patients' medical records. Contrast-enhanced CT images were assessed in following items: defect of mural enhancement, pneumatosis intestinalis, hepatic portal venous gas, paralytic bowel dilatation, bowel wall thinning, and diameters of the relevant vessels.Results Eight patients belonged to ''survivor'' group, whereas eleven were allocated to ''non-survivor'' group. None of CT findings showed significant difference between survivor group and non-survivor group [defect of mural enhancement: 75% and 100% (p = 0.16), pneumatosis intestinalis: 50% and 45.5% (p = 1.00), hepatic portal venous gas: 37.5% and 45.5% (p = 1.00), paralytic bowel dilatation: 12.5% and 63.6% (p = 0.06), and bowel wall thinning: 50% and 45.5% (p = 1.00)]. The diameters of the relevant vessels did not have significant difference either. Time from CT to injecting vasodilator was revealed to be significantly shorter in survivor group [187.5 (122.5-294) min and 310 (187-925.5)] (p = 0.048). None of the other clinical information had significant difference between each group.Conclusion Prompt angiography may be a key to improve the prognosis of NOMI patients.
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The shorter the time from CTA to direct vasodilator infusion, the better the chance of survival.
“One study showed that the shorter the time from CTA to direct vasodilator infusion, the better the chance of survival[103].”
From Ischemic bowel disease in 2021. (2021) · cites this paper as [103]
In another retrospective study of 21 consecutive patients with DSA proven NOMI, there were no differences in mesenteric vessel diameters on CTA between survivors (n=8) and non-survivors (n=11).
“Also, in another retrospective study of 21 consecutive patients with DSA proven NOMI, there were no differences in mesenteric vessel diameters on CTA between survivors ( n ¼ 8) and non-survivors ( n ¼ 11). 196”
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- Authors
- Miyazawa, R., & Kamo, M.
- Affiliations
- St. Luke's International Hospital (JP)
- Corresponding author
- Miyazawa, Ryo
- Venue
- Surgical Endoscopy
- Published
- 2019-12-12
- Volume
- 34
- Issue
- 12
- Pages
- 5327-5330
- ISSN
- 0930-2794 (ISSN-L)
- 1432-2218
- OpenAlex
- W2995833548
- Cited by
- 25
- References
- 11
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 4 · 2021: 3 · 2020: 2
- FWCI
- 2.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Surgical Endoscopy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Rheumatology › Omental and Epiploic Conditions
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- nonocclusive mesenteric ischemia, prognosis, prognostic factors, computed tomography findings, contrast-enhanced CT, angiography, vasodilator therapy, time to treatment, pneumatosis intestinalis, hepatic portal venous gas, Charlson Comorbidity Index, mortality
- MeSH terms
- Data Analysis, Female, Humans, Male, Prognosis, Retrospective Studies, Tomography, X-Ray Computed, Survival Analysis, Mesenteric Ischemia
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