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Nomogram for predicting transmural bowel infarction in patients with acute superior mesenteric venous thrombosis

World Journal of Gastroenterology 2020年第26期26卷 3800-3813页

作者： Meng Jiang Chang-Li Li Chun-Qiu Pan Wen-Zhi Lv Yu-Fei Ren Xin-Wu Cui Christoph F Dietrich Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine Department of Medical UltrasoundTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Department of Geratology Hubei Provincial Hospital of Integrated Chinese and Western MedicineWuhan 430015Hubei ProvinceChina Department of Emergency Medicine Nanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Artificial Intelligence Julei Technology CompanyWuhan 430030Hubei ProvinceChina Department of Computer Center Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Department of Internal Medicine Hirslanden ClinicBerne 27804Switzerland

BACKGROUND The prognosis of acute mesenteric ischemia(AMI)caused by superior mesenteric venous thrombosis(SMVT)remains undetermined and early detection of transmural bowel infarction(TBI)is *** predisposition to develop TBI is of clinical concern,which can lead to fatal sepsis with hemodynamic instability and multi-organ *** resection of necrotic bowel could improve the prognosis of AMI,however,accurate prediction of TBI remains a challenge for *** determining the eligibility for explorative laparotomy,the underlying risk factors for bowel infarction should be fully *** To develop and externally validate a nomogram for prediction of TBI in patients with acute *** Consecutive data from 207 acute SMVT patients at the Wuhan Tongji Hospital and 89 patients at the Guangzhou Nanfang Hospital between July 2005 and December 2018 were included in this *** were grouped as training and external validation *** 207 cases(training cohort)from Tongji Hospital were divided into TBI and reversible intestinal ischemia groups based on the final therapeutic *** and multivariate logistic regression analyses were conducted to identify independent risk factors for TBI using the training data,and a nomogram was subsequently *** performance of the nomogram was evaluated with respect to discrimination,calibration,and clinical usefulness in the training and external validation *** Univariate and multivariate logistic regression analyses identified the following independent prognostic factors associated with TBI in the training cohort:The decreased bowel wall enhancement(OR=6.37,P2 mmol/L(OR=3.14,P=0.009)and previous history of deep venous thrombosis(OR=6.37,P<0.001).Incorporating these four factors,the nomogram achieved good calibration in the training set[area under the receiver operator characteristic curve(AUC)0.860;95%CI:0.771

关键词： Superior mesenteric venous thrombosis Acute mesenteric ischemia Transmural bowel infarction reversible intestinal ischemia Predictors Nomogram

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