Unchanged high mortality rates from acute occlusive intestinal ischemia: six year review

Kassahun, Woubet Tefera; Schulz, Thomas; Richter, O.; Hauss, Johann

doi:10.1007/s00423-007-0263-5

Cited by 223 publications

(179 citation statements)

References 30 publications

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“…1,11 Kassahun et al reported survival rate of 50% in patients diagnosed within first 24 hours and less than 30% in those presenting after 24 hours of symptoms. 12 Majority of the times the delay in presentation to our tertiary referral centre was due to delayed referral from other hospitals due to diagnostic dilemma. Thus early admission and early diagnosis4 and treatment before gangrene sets in or progresses is vital for favourable outcome.…”

Section: Discussionmentioning

confidence: 99%

Predictors of mortality in acute mesenteric vascular ischemia with bowel gangrene

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Predictors of mortality in acute mesenteric vascular ischemia with bowel gangrene

et al. 2016

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“…Despite the considerable advances in the diagnosis and treatment of such patients and a better understanding of the pathophysiology of the disease, the mortality and morbidity still remain high [8]. The reasons for this are manifold.…”

Section: Discussionmentioning

confidence: 99%

Acute Mesenteric Ischaemia—An Indian Perspective

et al. 2014

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In Western countries, acute mesenteric ischaemia is commonly due to arterial occlusion and occurs in patients who are usually in their seventh decade. A venous cause for intestinal gangrene has been reported in only about 10 %. We examined whether this was so in India and compared the clinical features of patients with mesenteric arterial and venous ischaemia and relate these to their ultimate prognosis. We studied retrospectively, the records of all patients admitted or referred to the department with a diagnosis of acute mesenteric ischaemia between January 1997 and October 2012, noting their demographic details and mode of presentation, the results of preoperative imaging and blood investigations, the extent of bowel ischaemia, and the length of bowel that was resected at operation and their outcome. There were 117 patients, 85 males and 32 females whose median age was 53 years. Mesenteric venous thrombosis was seen in 56 patients (48 %) and mesenteric arterial occlusion in 61 (52 %). Forty six patients died (39 %); 15 with venous occlusion (27 %) and 31 with arterial occlusion (51 %). Compared to patients with arterial occlusion, the patients with venous obstruction were younger, had a longer duration of symptoms, were less frequently hypotensive at presentation, had higher platelet counts, had a shorter length of bowel resected, had fewer colonic resections and had a lower mortality. Other predictors of mortality on multivariate analysis were a longer duration of symptoms, lower serum albumin and higher creatinine levels at presentation and a shorter length of residual bowel. In India, acute mesenteric ischaemia in tertiary care centres is due to venous thrombosis in almost half of the patients who are at least a decade younger than those in the West. Significant predictors of mortality include low serum albumin and raised creatinine levels, a shorter residual bowel length and an arterial cause for mesenteric ischaemia.

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“…Yaşlı hastalarda bazı kriterler (>84 yaş, bandemi, batında serbest hava) yüksek mortalite, bazı kriterler ise (hipotansiyon, anormal barsak sesleri, masif dilate barsak ansları ve aşırı lökositoz) ise cerrahi müdahale gereksinimi ile ilişkilendirelebilirler, ancak bu kriterlerin yokluğu ciddi bir sorun olmadığı anlamına gelmemektedir. Viral gastroenteritlerin yaşlıda seyrek olduğunu, fakat ortaya çıkan ishallerin %31-40'ında altta yatan mezenter iskemi olduğununda unutulmaması önemlidir (24)(25)(26). Akut karın ağrısı ile acil servise başvuran geriatrik yaş grubunun incelendiği bir çalışmada ise; hastaların %60'nın yatarak izlendiği, %20'sinde invaziv bir girişim yapıldığı, taburcu edilen hastaların %10'unun yeniden acil servise başvurduğu ve daha da dramatik olarak % 5'inin iki haftalık takip süresi içinde hayatını kaybettiği saptanmıştır (9).…”

Section: Tanı Koymada Güçlüklerunclassified

Geriatrik hastada akut karın ağrısına yaklaşım

Ersel¹

2014

Ege Tıp Dergisi

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Dünya nüfusunun hızla yaşlanması sonucu acil servislere karın ağrısı ile başvuran geriatrik yaş grubu hasta sayısı da hızla artmaktadır. Değişen fizyoloji, komorbid hastalıklar, iletişim güçlükleri, çoklu ilaç kullanımı, yaşlı hastalarda akut karın tablosunda tanı koymayı güçleştirmektedir. Bu güçlüklere karşın bir çok hastanın organ spesifik tanısı acil serviste konmaktadır. Geriatrik yaş grubundaki hastalarda karın ağrısı tablosunda altta yatan bir cerrahi patoloji olma olasılığı yüksektir. Bu nedenle geriatrik hastaların karın ağrılarında tetkik ve konsültasyon istemleri diğer hasta gruplarına oranla daha hızlandırılmış ve öncelikli olarak yapılmalı, tanı güçlüğü çekilen hastalarda yatış ile gözlem ön plana alınmalıdır.Anahtar Sözcükler: Acil servis, acil yaklaşım, akut batın, geriatrik hasta. Summary As a result of rapidly aging of the world's population, the number of patients admits with complaint of acute abdominal pain to the emergency deparments in the geriatric age group is increasing. Changing physiology, comorbid disorders, barriers to communication and polypharmacy makes it difficult to make diagnosis in elderly patients

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Unchanged high mortality rates from acute occlusive intestinal ischemia: six year review

Abstract: AII remains a highly lethal condition. Mortality rates remain as high as they did decades ago due in part to advanced presentation and advanced age with multiple associated conditions and risk factors, all of which are independent predictors of adverse outcome.

Cited by 223 publications

References 30 publications

Predictors of mortality in acute mesenteric vascular ischemia with bowel gangrene

Predictors of mortality in acute mesenteric vascular ischemia with bowel gangrene

Acute Mesenteric Ischaemia—An Indian Perspective

Geriatrik hastada akut karın ağrısına yaklaşım

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