The geriatric index of comorbidity as an outcome predictor of patients with acute mesenteric ischemia due to superior mesentery artery thromboembolism

Author:

Lei Yan1,Tang Wei23ORCID,Zhang Xiaoming2,Wang Yi3ORCID

Affiliation:

1. Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong, China

2. Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China

3. Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China

Abstract

Objective To describe the impact of comorbidities on in-hospital mortality and overall survival in patients with acute mesenteric ischemia (AMI) due to superior mesentery artery (SMA) thromboembolism. Methods A retrospective study was conducted for 40 patients with AMI due to SMA thromboembolism who were treated in our hospital between February 2013 and December 2019. The presence of comorbidities was described and their severities were classified into 1–4 levels by Geriatric Index of Comorbidity (GIC), the comorbidities were defined as any distinct additional clinical entity that has existed. Univariate and cox proportional-hazards analyses were performed to determine the effect of comorbidities on in-hospital mortality and overall survival. Results During a mean follow-up of 15.05 ± 18.02 months (range from 0.3 to 58 months) for the 40 patients with AMI due to SMA thromboembolism, In-hospital mortality rate was 52.5% (21/40). One-year, 2-year, and 3-year overall estimated survival rates by the Kaplan–Meier method were 45%, 34%, and 26.5%, respectively, the average overall survival time was 20.84 ± 3.95 (95% CI: 13.10–28.58) months. In-hospital mortality was significantly related to the GIC classification ( χ2 = 7.86, p = 0.049). The average overall survival was significantly related to the malignant tumor in pre-existing comorbidities and GIC classification (log-rank, p = 0.001). Cox proportional-hazards regressions analysis showed that the class 4 of comorbidities was an independent prognostic factor of mortality ( p = 0.031, HR = 10.45 [95% CI: 1.24–87.70]). Conclusion Comorbidity is common and an important factor associated with all-cause mortality in AMI patients due to SMA thromboembolism. In managing AMI patients, we recommend a timely diagnosis of both AMI condition and its associated comorbidities.

Funder

Chongqing Clinical Research Centre of Imaging and Nuclear Medicine

Scientific research development project of Affiliated Hospital of North Sichuan Medical College

the opening project of Medical Imaging Key Laboratory of Sichuan Province

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine,Surgery

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