title: Clinical outcomes and prognostic factors after surgery for non-occlusive mesenteric ischemia: a multicenter study.
abstract: BACKGROUND
  To date, no large-scale study has been undertaken to understand the clinical features of non-occlusive mesenteric ischemia (NOMI) after surgery. We thus performed a multicenter investigation to clarify the clinical outcomes and prognostic factors of NOMI.
  
  
  METHODS
  Clinical databases from 22 Japanese facilities were reviewed for evaluation of patients who received surgery for NOMI between 2004 and 2012. NOMI patients (n = 51) were divided into two groups: group I (n = 28) consisted of patients who survived, and group II (n = 23) consisted of patients who did not survived. Prognostic factors were compared between the two groups.
  
  
  RESULTS
  NOMI surgery represented 0.04% of the total number of operations performed in this time period. The overall mortality rate for NOMI surgery was 45%. Hemodialysis was a significant negative prognostic factor (p = 0.027). Preoperative elevation of transaminases, potassium, and white blood cell count, as well as metabolic acidosis and colon ischemia was poor prognostic factors. The mean Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) score of group I versus group II was 54.5 ± 3.6 and 85.2 ± 4.1, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Currently, NOMI surgery has a 45% mortality rate. POSSUM scores can be used to predict the clinical outcome of patients who receive NOMI surgery.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan, t-yukaya@surg2.med.kyushu-u.ac.jp.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yukaya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Kenji
authors.initials: K
authors.lastname: Taketani
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ida
authors.forename: Yasue
authors.initials: Y
authors.lastname: Kimura
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yasuda
authors.forename: Masaru
authors.initials: M
authors.lastname: Morita
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000138:Acidosis / Q000150:complications; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D003106:Colon / Q000098:blood supply*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications*; D007958:Leukocyte Count; D008297:Male; D065666:Mesenteric Ischemia / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D057234:Preoperative Period; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D011188:Potassium