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Epidemiology, risk and prognostic factors in mesenteric venous thrombosis.

Acosta, Stefan LU ; Alhadad, Alaa LU ; Svensson, Peter LU and Ekberg, Olle LU (2008) In British Journal of Surgery Aug 21. p.1245-1251
Abstract
BACKGROUND:: Epidemiological reports on risk and prognostic factors in patients with mesenteric venous thrombosis (MVT) are scarce. METHODS:: Patients with MVT were identified through the inpatient and autopsy registry between 2000 and 2006 at Malmö University Hospital. RESULTS:: Fifty-one patients had MVT, diagnosed at autopsy in six. The highest incidence (11.3 per 100 000 person-years) was in the age category 70-79 years. Activated protein C resistance was present in 13 of 29 patients tested. D-dimer at admission was raised in all five patients tested. Multidetector row computed tomography (CT) in the portal venous phase was diagnostic in all 20 patients investigated, of whom 19 were managed conservatively. The median length of resected... (More)
BACKGROUND:: Epidemiological reports on risk and prognostic factors in patients with mesenteric venous thrombosis (MVT) are scarce. METHODS:: Patients with MVT were identified through the inpatient and autopsy registry between 2000 and 2006 at Malmö University Hospital. RESULTS:: Fifty-one patients had MVT, diagnosed at autopsy in six. The highest incidence (11.3 per 100 000 person-years) was in the age category 70-79 years. Activated protein C resistance was present in 13 of 29 patients tested. D-dimer at admission was raised in all five patients tested. Multidetector row computed tomography (CT) in the portal venous phase was diagnostic in all 20 patients investigated, of whom 19 were managed conservatively. The median length of resected bowel in 12 patients who had surgery was 0.6 (range 0.1-2.2) m. The overall 30-day mortality rate was 20 per cent; intestinal infarction (P = 0.046), treatment on a non-surgical ward (P = 0.001) and CT not done (P = 0.022) were associated with increased mortality. Cancer was independently associated with long-term mortality: hazard ratio 4.03, 95 per cent confidence interval 1.03 to 15.85; P = 0.046. CONCLUSION:: Portal venous phase CT appeared sensitive in diagnosing MVT. As activated protein C resistance was a strong risk factor, lifelong anticoagulation should be considered. Copyright (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
British Journal of Surgery
volume
Aug 21
pages
1245 - 1251
publisher
John Wiley & Sons
external identifiers
  • wos:000259713300007
  • pmid:18720461
  • scopus:52449091262
ISSN
1365-2168
DOI
10.1002/bjs.6319
language
English
LU publication?
yes
id
6f0e0db4-e8f5-445f-ac15-d680a351f00b (old id 1223003)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18720461?dopt=Abstract
date added to LUP
2008-09-02 15:04:31
date last changed
2017-11-05 04:44:44
@article{6f0e0db4-e8f5-445f-ac15-d680a351f00b,
  abstract     = {BACKGROUND:: Epidemiological reports on risk and prognostic factors in patients with mesenteric venous thrombosis (MVT) are scarce. METHODS:: Patients with MVT were identified through the inpatient and autopsy registry between 2000 and 2006 at Malmö University Hospital. RESULTS:: Fifty-one patients had MVT, diagnosed at autopsy in six. The highest incidence (11.3 per 100 000 person-years) was in the age category 70-79 years. Activated protein C resistance was present in 13 of 29 patients tested. D-dimer at admission was raised in all five patients tested. Multidetector row computed tomography (CT) in the portal venous phase was diagnostic in all 20 patients investigated, of whom 19 were managed conservatively. The median length of resected bowel in 12 patients who had surgery was 0.6 (range 0.1-2.2) m. The overall 30-day mortality rate was 20 per cent; intestinal infarction (P = 0.046), treatment on a non-surgical ward (P = 0.001) and CT not done (P = 0.022) were associated with increased mortality. Cancer was independently associated with long-term mortality: hazard ratio 4.03, 95 per cent confidence interval 1.03 to 15.85; P = 0.046. CONCLUSION:: Portal venous phase CT appeared sensitive in diagnosing MVT. As activated protein C resistance was a strong risk factor, lifelong anticoagulation should be considered. Copyright (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.},
  author       = {Acosta, Stefan and Alhadad, Alaa and Svensson, Peter and Ekberg, Olle},
  issn         = {1365-2168},
  language     = {eng},
  pages        = {1245--1251},
  publisher    = {John Wiley & Sons},
  series       = {British Journal of Surgery},
  title        = {Epidemiology, risk and prognostic factors in mesenteric venous thrombosis.},
  url          = {http://dx.doi.org/10.1002/bjs.6319},
  volume       = {Aug 21},
  year         = {2008},
}