Endovascular therapy for acute mesenteric ischemia

An NSQIP analysis

Bernardino C. Branco, Miguel F. Montero-Baker, Hassan Aziz, Zachary Taylor, Joseph L Mills

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Acute mesenteric ischemia (AMI) continues to carry high morbidity and mortality. Endovascular strategies have been increasingly used in the management of AMI. The purpose of this study was to evaluate the impact of endovascular therapy on outcomes of patients with AMI. The National Surgical Quality Improvement Program database was queried to identify all patients requiring emergency surgical intervention for AMI. Demographics, clinical data, interventions, and outcomes were extracted. Patients were compared according to treatment (endovascular versus hybrid versus open revascularization). Over the six-year study period, a total of 439 patients were found to have AMI [27 (6.2%) endovascular, 23 (5.2%) hybrid, and 389 (88.6%) open revascularization]. A total of 16 (59.3%) patients in the endovascular group avoided laparotomy. There was a trend toward lower transfusion requirements (intraoperative transfusion: 3.7% for endovascular vs 17.4% for hybrid vs 19.3% for open, adjusted. P 5 0.127) and complications in particular pneumonia (22.2% vs 39.1% vs 27.8%, respectively, Adj. P 5 0.392) and sepsis (25.9% vs 21.7% vs 35.5%, adjusted P 5 0.260). Endovascular therapy was associated with a 2.5-fold decrease in the risk of death [odds ratio, 95% confidence interval: 0.4 (0.2, 0.9), adjusted P 5 0.018]. In this analysis of morbidity and mortality, endovascular therapy was associated with decreased need for laparotomy and a trend toward lower transfusion requirements and complications, in particular pneumonia and sepsis. Endovascular first therapy was associated with a 2.5-fold decrease in the risk of death. Further prospective evaluation of these results is warranted.

Original languageEnglish (US)
Pages (from-to)1170-1176
Number of pages7
JournalAmerican Surgeon
Volume81
Issue number11
StatePublished - Nov 1 2015
Externally publishedYes

Fingerprint

Laparotomy
Sepsis
Pneumonia
Morbidity
Therapeutics
Mortality
Quality Improvement
Emergencies
Odds Ratio
Demography
Mesenteric Ischemia
Databases
Confidence Intervals

ASJC Scopus subject areas

  • Surgery

Cite this

Branco, B. C., Montero-Baker, M. F., Aziz, H., Taylor, Z., & Mills, J. L. (2015). Endovascular therapy for acute mesenteric ischemia: An NSQIP analysis. American Surgeon, 81(11), 1170-1176.

Endovascular therapy for acute mesenteric ischemia : An NSQIP analysis. / Branco, Bernardino C.; Montero-Baker, Miguel F.; Aziz, Hassan; Taylor, Zachary; Mills, Joseph L.

In: American Surgeon, Vol. 81, No. 11, 01.11.2015, p. 1170-1176.

Research output: Contribution to journalArticle

Branco, BC, Montero-Baker, MF, Aziz, H, Taylor, Z & Mills, JL 2015, 'Endovascular therapy for acute mesenteric ischemia: An NSQIP analysis', American Surgeon, vol. 81, no. 11, pp. 1170-1176.
Branco BC, Montero-Baker MF, Aziz H, Taylor Z, Mills JL. Endovascular therapy for acute mesenteric ischemia: An NSQIP analysis. American Surgeon. 2015 Nov 1;81(11):1170-1176.
Branco, Bernardino C. ; Montero-Baker, Miguel F. ; Aziz, Hassan ; Taylor, Zachary ; Mills, Joseph L. / Endovascular therapy for acute mesenteric ischemia : An NSQIP analysis. In: American Surgeon. 2015 ; Vol. 81, No. 11. pp. 1170-1176.
@article{97148e9cd3134775b0922dd9b4758228,
title = "Endovascular therapy for acute mesenteric ischemia: An NSQIP analysis",
abstract = "Acute mesenteric ischemia (AMI) continues to carry high morbidity and mortality. Endovascular strategies have been increasingly used in the management of AMI. The purpose of this study was to evaluate the impact of endovascular therapy on outcomes of patients with AMI. The National Surgical Quality Improvement Program database was queried to identify all patients requiring emergency surgical intervention for AMI. Demographics, clinical data, interventions, and outcomes were extracted. Patients were compared according to treatment (endovascular versus hybrid versus open revascularization). Over the six-year study period, a total of 439 patients were found to have AMI [27 (6.2{\%}) endovascular, 23 (5.2{\%}) hybrid, and 389 (88.6{\%}) open revascularization]. A total of 16 (59.3{\%}) patients in the endovascular group avoided laparotomy. There was a trend toward lower transfusion requirements (intraoperative transfusion: 3.7{\%} for endovascular vs 17.4{\%} for hybrid vs 19.3{\%} for open, adjusted. P 5 0.127) and complications in particular pneumonia (22.2{\%} vs 39.1{\%} vs 27.8{\%}, respectively, Adj. P 5 0.392) and sepsis (25.9{\%} vs 21.7{\%} vs 35.5{\%}, adjusted P 5 0.260). Endovascular therapy was associated with a 2.5-fold decrease in the risk of death [odds ratio, 95{\%} confidence interval: 0.4 (0.2, 0.9), adjusted P 5 0.018]. In this analysis of morbidity and mortality, endovascular therapy was associated with decreased need for laparotomy and a trend toward lower transfusion requirements and complications, in particular pneumonia and sepsis. Endovascular first therapy was associated with a 2.5-fold decrease in the risk of death. Further prospective evaluation of these results is warranted.",
author = "Branco, {Bernardino C.} and Montero-Baker, {Miguel F.} and Hassan Aziz and Zachary Taylor and Mills, {Joseph L}",
year = "2015",
month = "11",
day = "1",
language = "English (US)",
volume = "81",
pages = "1170--1176",
journal = "American Surgeon",
issn = "0003-1348",
publisher = "Southeastern Surgical Congress",
number = "11",

}

TY - JOUR

T1 - Endovascular therapy for acute mesenteric ischemia

T2 - An NSQIP analysis

AU - Branco, Bernardino C.

AU - Montero-Baker, Miguel F.

AU - Aziz, Hassan

AU - Taylor, Zachary

AU - Mills, Joseph L

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Acute mesenteric ischemia (AMI) continues to carry high morbidity and mortality. Endovascular strategies have been increasingly used in the management of AMI. The purpose of this study was to evaluate the impact of endovascular therapy on outcomes of patients with AMI. The National Surgical Quality Improvement Program database was queried to identify all patients requiring emergency surgical intervention for AMI. Demographics, clinical data, interventions, and outcomes were extracted. Patients were compared according to treatment (endovascular versus hybrid versus open revascularization). Over the six-year study period, a total of 439 patients were found to have AMI [27 (6.2%) endovascular, 23 (5.2%) hybrid, and 389 (88.6%) open revascularization]. A total of 16 (59.3%) patients in the endovascular group avoided laparotomy. There was a trend toward lower transfusion requirements (intraoperative transfusion: 3.7% for endovascular vs 17.4% for hybrid vs 19.3% for open, adjusted. P 5 0.127) and complications in particular pneumonia (22.2% vs 39.1% vs 27.8%, respectively, Adj. P 5 0.392) and sepsis (25.9% vs 21.7% vs 35.5%, adjusted P 5 0.260). Endovascular therapy was associated with a 2.5-fold decrease in the risk of death [odds ratio, 95% confidence interval: 0.4 (0.2, 0.9), adjusted P 5 0.018]. In this analysis of morbidity and mortality, endovascular therapy was associated with decreased need for laparotomy and a trend toward lower transfusion requirements and complications, in particular pneumonia and sepsis. Endovascular first therapy was associated with a 2.5-fold decrease in the risk of death. Further prospective evaluation of these results is warranted.

AB - Acute mesenteric ischemia (AMI) continues to carry high morbidity and mortality. Endovascular strategies have been increasingly used in the management of AMI. The purpose of this study was to evaluate the impact of endovascular therapy on outcomes of patients with AMI. The National Surgical Quality Improvement Program database was queried to identify all patients requiring emergency surgical intervention for AMI. Demographics, clinical data, interventions, and outcomes were extracted. Patients were compared according to treatment (endovascular versus hybrid versus open revascularization). Over the six-year study period, a total of 439 patients were found to have AMI [27 (6.2%) endovascular, 23 (5.2%) hybrid, and 389 (88.6%) open revascularization]. A total of 16 (59.3%) patients in the endovascular group avoided laparotomy. There was a trend toward lower transfusion requirements (intraoperative transfusion: 3.7% for endovascular vs 17.4% for hybrid vs 19.3% for open, adjusted. P 5 0.127) and complications in particular pneumonia (22.2% vs 39.1% vs 27.8%, respectively, Adj. P 5 0.392) and sepsis (25.9% vs 21.7% vs 35.5%, adjusted P 5 0.260). Endovascular therapy was associated with a 2.5-fold decrease in the risk of death [odds ratio, 95% confidence interval: 0.4 (0.2, 0.9), adjusted P 5 0.018]. In this analysis of morbidity and mortality, endovascular therapy was associated with decreased need for laparotomy and a trend toward lower transfusion requirements and complications, in particular pneumonia and sepsis. Endovascular first therapy was associated with a 2.5-fold decrease in the risk of death. Further prospective evaluation of these results is warranted.

UR - http://www.scopus.com/inward/record.url?scp=84951024508&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84951024508&partnerID=8YFLogxK

M3 - Article

VL - 81

SP - 1170

EP - 1176

JO - American Surgeon

JF - American Surgeon

SN - 0003-1348

IS - 11

ER -