Outcomes after open and endovascular treatment for mesenteric artery embolism patients: a retrospective inverse probability of treatment-weighted analysis

• Published in: European journal of trauma and emergency surgery (Munich : 2007) 2024-12, Vol.50 (6), p.2883-2893
• Main Authors: Qiu, Yi-hui, Zhang, Yin-he, Wu, Zi-chang, Yang, Zhe, Zhu, Guan-xia, Miao, Shou-liang, Chen, Bi-cheng, Chen, Fan-feng
• Format: Article
• Language: English
• Subjects: Aged; Critical Care Medicine; Embolism - mortality; Embolisms; Emergency Medicine; Endovascular Procedures - methods; Female; Fibrin Fibrinogen Degradation Products - analysis; Fibrin Fibrinogen Degradation Products - metabolism; Humans; Intensive; Laparotomy; Male; Medicine; Medicine & Public Health; Mesenteric Vascular Occlusion - mortality; Mesenteric Vascular Occlusion - surgery; Middle Aged; Mortality; Original Article; Regression analysis; Retrospective Studies; Risk Factors; Sports Medicine; Surgery; Surgical Orthopedics; Traumatic Surgery; Treatment Outcome
• ISSN: 1863-9933; 1863-9941; 1863-9941
• DOI: 10.1007/s00068-024-02647-z

Purpose This study aims to evaluate outcomes in patients with mesenteric artery embolism (MAE) who received primary endovascular therapy (EVT) or laparotomy, and investigate risk factors for 30-day mortality. Methods A retrospective analysis of 94 MAE patients who underwent two different treatment strategies was undertaken. An inverse probability of treatment weighting (IPTW) method was used to balance the confounding effects of baseline clinical data. Logistic regression analysis was performed to compare the outcomes according to type of treatment regimens before and after IPTW. Univariate and multivariable analysis were conducted to determine the risk factors for 30-day mortality. Results Twenty-eight MAE patients received primary EVT, and 66 Open Surgery (OS). Logistic regression analysis showed that there was no significant difference between the EVT and OS group in 30-day mortality rate before (odds ratio [OR] 0.477, 95% confidence interval [CI] 0.170 to 1.340, P  = 0.160), and after IPTW (OR 0.647, 95% CI 0.210 to 1.993, P  = 0.449). After IPTW, it revealed that the rates of second-look surgery (OR 36.727, 95% CI 5.407 to 249.458, P   30 days] (OR 0.006, 95% CI 0.000 to 0.363, P  = 0.014) were different in the two groups. D-dimer (> 4 mg/L) and procalcitonin (> 0.5 ng/mL) were the independent risk factors for 30-day mortality in MAE patients postoperatively ( P