Evidence map›Paper›PMID 37227462›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023

Factors associated with the need for long-term total parenteral nutrition in survivors of acute superior mesenteric artery occlusion.

Yuki Nakao, Hideki Sasanuma, Naohiro Sata, Nobumi Tagaya, Kenji Matsumoto, Taiki Mizobuchi, Fumiki Koga, Errington Thompson, Alan Lefor

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Acute mesenteric ischemia: diagnostic and therapeutic challenges.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yuki NakaoDepartment of General Surgery, Marshall University School of Medicine, 1600 Medical Center Drive, Suite 2500, Huntington, WV, 25701, USA. nakao@marshall.edu.ORCID http://orcid.org/0000-0002-6369-018X
Hideki SasanumaDepartment of Gastroenterology and General Surgery, Jichi Medical University, 3311-1, Shimotsukeshi Yakushiji, Tochigi, 329-0498, Japan.
Naohiro SataDepartment of Gastroenterology and General Surgery, Jichi Medical University, 3311-1, Shimotsukeshi Yakushiji, Tochigi, 329-0498, Japan.
Nobumi TagayaDepartment of Surgery, Digestive Disease Center, Itabashi Chuo Medical Center, 2-12-7, Itabashiku, Tokyo, 174-0051, Japan.
Kenji MatsumotoDepartment of Surgery, Saiseikai Utsunomiya Hospital, 911-1, Utsunomiyashi, Tochigi, 321-0974, Japan.
Taiki MizobuchiDepartment of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyoku, Tokyo, 113-8603, Japan.
Fumiki KogaDepartment of Surgery, Kurume University, 67, Kurumeshi Asahicho, Fukuoka, 830-0011, Japan.
Errington ThompsonDepartment of General Surgery, Marshall University School of Medicine, 1600 Medical Center Drive, Suite 2500, Huntington, WV, 25701, USA.
Alan LeforDepartment of Gastroenterology and General Surgery, Jichi Medical University, 3311-1, Shimotsukeshi Yakushiji, Tochigi, 329-0498, Japan.

Funding

the Japan Society of Abdominal Emergency Medicine 21-2
6 · The paper itself

Abstract

backgroundAcute superior mesenteric artery (SMA) occlusion is an uncommon condition associated with high mortality. If extensive bowel resection is performed for patients with acute SMA occlusion and the patient survives, long-term total parenteral nutrition (TPN) may be needed due to short bowel syndrome. This study examined factors associated with the need for long-term TPN after the treatment of acute SMA occlusion.

methodsWe retrospectively analyzed 78 patients with acute SMA occlusion. Patients were abstracted from a Japanese database from institutions with at least 10 patients with acute SMA occlusive disease from January 2015 through December 2020

resultsAmong the initial cohort there were 41/78 survivors. Of these, 14/41 (34%) required permanent TPN who were compared with those who did not require long-term TPN (27/41, 66%). Compared to patients in the non-TPN group, those in the TPN group had significantly shorter remaining small intestine (90.7 cm vs. 218 cm, P<0.01), more patients with time from onset to intervention >6 hours (P=0.02), pneumatosis intestinalis on enhanced computed tomography scan (P=0.04), ascites (Odds Ratio 11.6, P<0.01), and a positive smaller superior mesenteric vein sign (P= 0.03). These were considered significant risk factors for needing long-term TPN. Age, gender, underlying disease, presence of peritoneal sign, presence of shock requiring vasopressors, site of obstruction (proximal vs. distal), and initial treatment (surgery vs. interventional radiology vs. thrombolytic therapy) were not significantly different between the two groups. Long-term TPN was significantly associated with longer hospital stay (52 vs. 35 days, P=0.04). Multivariate analysis identified the presence of ascites as an independent risk factor for needing long-term TPN.

conclusionThe need for permanent TPN after treatment of acute SMA occlusion is significantly associated with longer hospital stay, longer time to intervention, and characteristic imaging findings (pneumatosis intestinalis, ascites, Smaller SMV sign). Ascites is an independent risk factor. LEVEL OF EVIDENCE: III.

Indexed as

AscitesMesenteric Artery, SuperiorHumansIschemiaParenteral Nutrition, TotalRetrospective StudiesAcute mesenteric ischemiaMesenteric artery occlusionTotal parenteral nutrition

Identifiers

PMID37227462

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.