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Atherosclerosis is associated with poorer outcome in non-occlusive mesenteric ischemia.

Authors
  • Juif, Arnaud1
  • Calame, Paul2
  • Winiszewski, Hadrien3
  • Turco, Celia4
  • Verdot, Pierre1
  • Pili-Floury, Sebastien5
  • Piton, Gael3
  • Delabrousse, Eric1
  • 1 Department of Radiology, University of Bourgogne Franche-Comté, CHRU Besançon, 25030, Besançon, France. , (France)
  • 2 Department of Radiology, University of Bourgogne Franche-Comté, CHRU Besançon, 25030, Besançon, France. Electronic address: [email protected] , (France)
  • 3 Medical Intensive Care Unit, University of Bourgogne Franche-Comté, CHRU Besançon, 25030, Besançon, France. , (France)
  • 4 Digestive Surgery Unit, University of Bourgogne Franche-Comté, CHRU Besançon, 25030, Besançon, France. , (France)
  • 5 Surgical Intensive Care Unit, University of Bourgogne Franche-Comté, CHRU Besançon, France. , (France)
Type
Published Article
Journal
European journal of radiology
Publication Date
Nov 30, 2020
Volume
134
Pages
109453–109453
Identifiers
DOI: 10.1016/j.ejrad.2020.109453
PMID: 33290974
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To evaluate whether abdominal atherosclerosis was associated with poorer outcome in a single-centre cohort of patients suffering from nonocclusive mesenteric ischemia (NOMI). From January 2009 to December 2019, 121 consecutive patients from the critical care unit who underwent laparotomy for suspected NOMI and with available unenhanced and contrast-enhanced CT were included. Clinical and biological data at the time of the CT scan were retrospectively extracted from medical charts and reviewed by a single radiologist. Unenhanced CT acquisitions were used to calculate calcium scores of the abdominal aorta, celiac trunk, superior mesenteric artery (SMA) and common iliac arteries according to the Agatston method. Univariate and multivariate analysis were performed. Among the 121 patients with NOMI and calcium score calculation, only 4 patients had no aortic calcifications (3 %) and 32 had no superior mesenteric artery calcification (26 %). 35 patients (29 %) died within 24 h after the abdominal CT scan. Univariate analysis showed that a total abdominal calcium score greater than 15 000 (last quartile) was significantly associated with death within 24 h (14 (40 %) vs 17 (20 %) patients, p = 0.035). By multivariate analysis, a total abdominal calcium score greater than 15 000 was an independent risk factor for death (HR = 1.94, 95 %CI [1.02-3.73], p = 0.044). Regarding separate calcium scores, only a SMA calcium score greater than 50 was a risk factor for death (HR 2.46, 95 %CI [1.14-3.93], p = 0.019). Our results show that abdominal atherosclerosis, especially in the SMA, is associated with poorer outcome in NOMI. Copyright © 2020 Elsevier B.V. All rights reserved.

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