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Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients with Acute Mesenteric Ischemia.
Ann Vasc Surg. 2020 Aug; 67:105-114.AV

Abstract

BACKGROUND

This study was performed to determine the association of frailty and comorbidity status with postoperative morbidity and mortality in patients with acute mesenteric ischemia (AMI).

METHODS

Patients diagnosed with AMI between April 2006 and September 2019 were enrolled in this study. Frailty was evaluated by sarcopenia which was diagnosed by third lumbar vertebra psoas muscle area (PMA). Comorbidity status was evaluated by the Charlson Comorbidity Index (CCI) score. Univariate and multivariate analyses evaluating the risk factors for postoperative morbidity and mortality were performed.

RESULTS

Of the 174 patients, 86 were managed conservatively and 88 underwent surgery. In surgically managed patients, 39.8% developed complications within 30 days of surgery. Ten patients died within 30 days of the operation. In the univariate analyses, white blood cell >10 g/L, low PMA, CCI score ≥2, and bowel resection were associated with postoperative complications. Multivariate analysis revealed that low PMA, CCI score ≥2, and bowel resection were independent predictors of postoperative complications.

CONCLUSIONS

This study demonstrated that low PMA, CCI score ≥2, and bowel resection were independent risk factors for postoperative complications in patients with AMI. Preoperative assessment of frailty using PMA and the evaluation of comorbidity status using CCI may serve as helpful tools in preoperative risk assessment and should be integrated into scoring systems for surgically treated AMI.

Authors+Show Affiliations

Department of Vascular Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.The First Clinical Medical College, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.The First Clinical Medical College, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.Department of Oncology, The First Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.Department of Radiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.Department of Vascular Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.Department of Vascular Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. Electronic address: vasqiuyihui@hotmail.com.Department of Vascular Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. Electronic address: wzhjy96@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32240729

Citation

Chen, Fan-Feng, et al. "Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients With Acute Mesenteric Ischemia." Annals of Vascular Surgery, vol. 67, 2020, pp. 105-114.
Chen FF, Ye XN, Jiang HT, et al. Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients with Acute Mesenteric Ischemia. Ann Vasc Surg. 2020;67:105-114.
Chen, F. F., Ye, X. N., Jiang, H. T., Zhu, G. X., Miao, S. L., Yu, G. F., Qiu, Y. H., & Huang, J. Y. (2020). Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients with Acute Mesenteric Ischemia. Annals of Vascular Surgery, 67, 105-114. https://doi.org/10.1016/j.avsg.2020.03.037
Chen FF, et al. Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients With Acute Mesenteric Ischemia. Ann Vasc Surg. 2020;67:105-114. PubMed PMID: 32240729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients with Acute Mesenteric Ischemia. AU - Chen,Fan-Feng, AU - Ye,Xiao-Ning, AU - Jiang,Hao-Te, AU - Zhu,Guan-Xia, AU - Miao,Shou-Liang, AU - Yu,Guan-Feng, AU - Qiu,Yi-Hui, AU - Huang,Jing-Yong, Y1 - 2020/03/30/ PY - 2020/01/04/received PY - 2020/02/21/revised PY - 2020/03/14/accepted PY - 2020/4/3/pubmed PY - 2020/10/27/medline PY - 2020/4/3/entrez SP - 105 EP - 114 JF - Annals of vascular surgery JO - Ann Vasc Surg VL - 67 N2 - BACKGROUND: This study was performed to determine the association of frailty and comorbidity status with postoperative morbidity and mortality in patients with acute mesenteric ischemia (AMI). METHODS: Patients diagnosed with AMI between April 2006 and September 2019 were enrolled in this study. Frailty was evaluated by sarcopenia which was diagnosed by third lumbar vertebra psoas muscle area (PMA). Comorbidity status was evaluated by the Charlson Comorbidity Index (CCI) score. Univariate and multivariate analyses evaluating the risk factors for postoperative morbidity and mortality were performed. RESULTS: Of the 174 patients, 86 were managed conservatively and 88 underwent surgery. In surgically managed patients, 39.8% developed complications within 30 days of surgery. Ten patients died within 30 days of the operation. In the univariate analyses, white blood cell >10 g/L, low PMA, CCI score ≥2, and bowel resection were associated with postoperative complications. Multivariate analysis revealed that low PMA, CCI score ≥2, and bowel resection were independent predictors of postoperative complications. CONCLUSIONS: This study demonstrated that low PMA, CCI score ≥2, and bowel resection were independent risk factors for postoperative complications in patients with AMI. Preoperative assessment of frailty using PMA and the evaluation of comorbidity status using CCI may serve as helpful tools in preoperative risk assessment and should be integrated into scoring systems for surgically treated AMI. SN - 1615-5947 UR - https://www.unboundmedicine.com/medline/citation/32240729/Role_of_Frailty_and_Comorbidity_Status_in_Predicting_Morbidity_and_Mortality_in_Patients_with_Acute_Mesenteric_Ischemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(20)30274-0 DB - PRIME DP - Unbound Medicine ER -