| Prognostic factors and treatment outcome in mesenteric vein thrombosis. | |
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MedLine Citation:
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PMID: 18332399 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Mesenteric vein thrombosis (MVT) can result in intestinal ischemia and is associated with high morbidity and mortality due in part to its frequent delay in diagnosis. The purpose of this study was to evaluate clinical presentation, diagnostic evaluation, and treatment outcome of MVT. METHODS: Hospital records and clinical data of all patients treated for MVT were reviewed during a recent 14-year period. Clinical outcome and factors affecting survival were analyzed. RESULTS: A total of 68 patients were included in the study. Abdominal exploration was performed in 23 patients (34%), and second-look operation was necessary in 18 patients (26%). Three patients (4%) underwent unsuccessful operative mesenteric vein thrombectomy, whereas percutaneous transhepatic mesenteric thrombectomy was performed successfully in 3 patients (4%). The 30-day mortality rate was 20%. Forty-six of the 54 survivors were treated with long-term oral anticoagulation therapy. Actuarial survival at 2, 4, 6, and 10 years was 68%, 57%, 43%, and 22%, respectively. Risk factor analysis showed malignancy (P < .002), age >60 years (P < .005), cirrhosis (P < .02), symptom duration (P < .005), and bowel resection (P < .03) were associated with mortality. Logistic regression analysis showed age >60 years (odds ratio [OR], 3.64; P = .03), malignancy (OR, 3.88; P = .02), and prolonged symptom duration (OR, 5.62; P = .01) were independent predictors of mortality. CONCLUSIONS: MVT is associated with significant mortality. Prompt diagnostic evaluation with computed tomography may reduce potential treatment delay. Underlying malignancy, advanced age, and prolonged symptom duration are predictive of poor outcome. |
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Authors:
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Nasim Hedayati; Gordon M Riha; Panagiotis Kougias; Tam T Huynh; Charlie Cheng; Carlos Bechara; Jean Bismuth; Alan Dardik; Peter H Lin |
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Publication Detail:
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Type: Journal Article Date: 2008-03-10 |
Journal Detail:
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Title: Vascular and endovascular surgery Volume: 42 ISSN: 1538-5744 ISO Abbreviation: Vasc Endovascular Surg Publication Date: 2008 Jun-Jul |
Date Detail:
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Created Date: 2008-07-31 Completed Date: 2008-10-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101136421 Medline TA: Vasc Endovascular Surg Country: United States |
Other Details:
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Languages: eng Pagination: 217-24 Citation Subset: IM |
Affiliation:
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Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Age Factors Aged Aged, 80 and over Anticoagulants / administration & dosage* Drug Administration Schedule Female Humans Logistic Models Male Mesenteric Vascular Occlusion / mortality, radiography, therapy* Mesenteric Veins / surgery Middle Aged Neoplasms / complications Odds Ratio Retrospective Studies Risk Assessment Risk Factors Thrombectomy* Time Factors Tomography, X-Ray Computed Treatment Outcome Venous Thrombosis / mortality, radiography, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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