Non-occlusive mesenteric ischemia in critically ill patients
Open accessAbstract
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is a life-threatening acute condition that has an overall in-hospital mortality rate of up to 75%. Critically ill patients are often admitted to intensive care units (ICUs) due to shock, and these patients are frequently at risk of developing NOMI. The objective of this study was to determine the clinical features of critically ill patients with NOMI and evaluate the risk factors for in-hospital mortality among these patients. METHODS: We reviewed the electronic medical records of 7,346 patients who underwent abdominal contrast-enhanced computed tomography during their ICU stay at Samsung Medical Center (Seoul, Korea) between January 1, 2010 and December 31, 2019. After reviewing each patient's computed tomography (CT) scans, 60 patients were diagnosed with NOMI and included in this analysis. The patients were divided into survivor (n = 23) and non-survivor (n = 37) groups according to the in-hospital mortality. RESULTS: The overall sequential organ failure assessment (SOFA) score for the included patients upon admission to the ICU was 8.6 ± 3.1, and medical ICU admissions were most common (66.7%) among the patients. The SOFA score upon admission to the ICU was higher for the non-survivors than for the survivors (9.4 vs. 7.4; p = 0.017). Non-survivors were more often observed in the medical ICU admissions (39.1% vs. 83.8%) than in the surgical ICU admissions (47.8% vs. 10.8%) or the cardiac ICU admissions (13.0% vs. 5.4%). Laboratory test results, abdominal CT findings, and the use of vasopressors and inotropes did not differ between the two groups. In a multivariable analysis, SOFA scores >8 upon admission to the ICU (odds ratio [OR] 4.51; 95% 1.12-18.13; p = 0.034), patients admitted to the ICU with medical problems (OR 7.99; 95% 1.73-36.94; p = 0.008), and abdominal pain (OR 4.26; 95% 1.05-17.35; p = 0.043) were significant prognostic predictors for in-hospital mortality. CONCLUSIONS: The SOFA score >8 upon admission to the ICU, admission to the ICU for medical problems, and abdominal pain at diagnosis are associated with increased mortality among patients with NOMI.
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NOMI is a result of hypoperfusion (from sepsis, shock, cardiac failure) and use of vasoconstrictors.
“NOMI is a result of hypoperfusion (from sepsis, shock, cardiac failure) and use of vasoconstrictors (Fig. 1c).”
From Acute mesenteric ischaemia (2023) · cites this paper as [13]
The Introduction (page unavailable) identifies septic and cardiogenic shock as risk factors for NOMI. The Discussion (page unavailable) says reports suggest an association between vasopressors and NOMI development and describes vasoconstriction reducing intestinal blood flow. The claim presents these factors as established causes and extends septic shock to sepsis generally; the paper does not make those stronger claims. (LLM, conf=0.84)
Experimental — accuracy not yet measuredNon-occlusive mesenteric ischaemia typically occurs in patients in the ICU or cardiac care unit.
“Patients with non-occlusive mesenteric ischaemia (NOMI) typically come from the ICU or cardiac care unit11–13.”
From Acute mesenteric ischaemia (2023) · cites this paper as [13]
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“Additionally, it is difficult to interpret inflammatory markers in patients with NOMI who usually have an active inflammatory state due to their severe underlying illness and its treatment (e.g. ICU patients) [98, 99].”
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- Authors
- Yu, B., Ko, R.-E., Yoo, K., Gil, E., Choi, K.-J., & Park, C.-M.
- Affiliations
- Samsung Medical Center (KR)
- Corresponding author
- Park, Chi-Min
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2022-12-19
- Volume
- 17
- Issue
- 12
- Pages
- e0279196
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC9762570
- OpenAlex
- W4311912035
- Cited by
- 27
- References
- 27
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 12 · 2023: 7
- FWCI
- 5.01
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
- Keywords
- nonocclusive mesenteric ischemia, critically ill patients, in-hospital mortality, risk factors, SOFA score, abdominal pain, shock, intensive care unit admission, medical ICU, contrast-enhanced abdominal CT, mortality prediction model, prognostic model, clinical features, sepsis, multiple organ failure, vasopressors, inotropic agents
- MeSH terms
- Hospitalization, Humans, Intensive Care Units, Prognosis, Retrospective Studies, Critical Illness, Hospital Mortality, Organ Dysfunction Scores, Mesenteric Ischemia
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