title: New prediction rule for mortality in acute mesenteric ischemia.
abstract: OBJECTIVE
  Acute mesenteric ischemia is potentially fatal, but prognostic factors have not yet been established. This study was undertaken to elucidate them.
  
  
  METHODS
  This is a retrospective cohort study, consisting of 110 patients who had been treated in the past 5 years, from 26 national hospitals in Japan.
  
  
  RESULTS
  The overall in-hospital mortality rate was 51%. Logistic regression analysis demonstrated two independent prognostic factors, electrocardiogram scale with an odds ratio of 1.7 (95% CI 1.2-2.4) and shock index of 11 (95% CI 1.5-80). A stepwise analysis gave a prediction equation for in-hospital mortality (R) using these variables and age score. We further modified this equation to a simpler scoring system (S) using the same variables. Both R and S showed a good discriminatory ability as determined by areas under the receiver-operating characteristic curve (0.83, 95% CI: 0.74-0.91 for R; 0.82, 95% CI 0.74-0.91 for S). The observed mortality rates increased as the R or S increased (19% at R <0.25, 41% at 0.25 < or = R <0.6, 85% at R > or =0.6; 19% at S < or =2, 37% at S of 3 or 4, 91% at S > or =5).
  
  
  CONCLUSIONS
  The new prediction rules can be used at any hospital and may be promising tools for medical decision-making, informed consent and reviewing quality of care.
authors: Department of Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan. epass2006@yahoo.co.jp
authors: Yoshio
authors: Y
authors: Haga
authors: Masaharu
authors: M
authors: Odo
authors: Masato
authors: M
authors: Homma
authors: Kenichi
authors: K
authors: Komiya
authors: Kazunori
authors: K
authors: Takeda
authors: Shoichiro
authors: S
authors: Koike
authors: Tadateru
authors: T
authors: Takahashi
authors: Kiyohisa
authors: K
authors: Hiraka
authors: Haruhiro
authors: H
authors: Yamashita
authors: Kohji
authors: K
authors: Tanakaya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D017052:Hospital Mortality; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D007564:Japan; D008638:Mesenteric Arteries; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D008642:Mesenteric Veins; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis