Mesenteric venous thrombosis and factors associated with mortality: a statistical analysis with five-year follow-up.
OBJECTIVE
The objective was to study the factors associated with mortality in mesenteric venous thrombosis (MVT).


METHODS
We reviewed all cases of bowel ischemia at our institute from 1984 to 2004 and identified 31 cases of MVT and compiled data concerning their demographics, risk factors, investigations, management, surgical procedures, and outcomes. Survival was analyzed for both 30-day and 5-year periods.


RESULTS
Analysis of factors associated with mortality in our 31 case series revealed that 30-day mortality was strongly associated with colonic involvement in ischemia (p = .008) as well as short bowel syndrome (p = .028) and possibly failure to anti-coagulate the patient (p = .07). While 5-year mortality was strongly associated with "short bowel syndrome" as defined by small bowel remaining less than 100 cm (p = .031). Further study using a multivariate Cox proportional hazard analysis showed that mortality within the 30-day period was mainly related to colon ischemia with p value of .014 and an odds ratio of 17.4, while short-bowel syndrome was the predominated factor in the 5-year mortality analysis with a p value of .029 and an odds ratio of 5.


CONCLUSIONS
Thirty-day mortality for MVT is strongly associated with colonic involvement as well as "short-bowel" syndrome, while anticoagulation may be protective. Five-year survival was found to be strongly associated with "short-bowel" syndrome.
Abu-Daff
S
S
Department of Surgery, Riyadh Military Hospital, Riyadh, Saudi Arabia. sabudaff@rmh.gov.sa
Abu-Daff
N
N
Al-Shahed
M
M
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D003106:Colon / Q000098:blood supply; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015994:Incidence; D007421:Intestine, Small / Q000098:blood supply; D016015:Logistic Models; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D008642:Mesenteric Veins; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011336:Probability; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D017131:Thrombectomy / Q000009:adverse effects / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D055815:Young Adult