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Clinical features and outcomes of nonocclusive mesenteric ischemia after cardiac surgery: a retrospective cohort study

  • Takashi SakamotoEmail author
  • Michimasa Fujiogi
  • Hiroki Matsui
  • Kiyohide Fushimi
  • Hideo Yasunaga
Original Article

Abstract

Nonocclusive mesenteric ischemia after cardiac surgery is a life-threatening complication requiring emergent intervention. However, because of its rarity, the clinical features and outcomes of nonocclusive mesenteric ischemia remain unknown. The present study aimed to clarify patients’ backgrounds, clinical features and mortality of nonocclusive mesenteric ischemia after cardiac surgery, using a Japanese national inpatient database. We identified patients undergoing cardiac or thoracic aortic surgery between July 2010 and March 2017, using the Japanese Diagnosis Procedure Combination database. We calculated the incidence proportion of nonocclusive mesenteric ischemia and examined treatment options (bowel resection and interventional radiology) and patients’ discharge status (in-hospital mortality and destination of discharge). We identified 221,900 eligible patients to find 568 (0.26%) patients with bowel ischemia in the same admission. Of these, 124 (0.06%) patients developed nonocclusive mesenteric ischemia, and in-hospital mortality after nonocclusive mesenteric ischemia was 77%. Treatment options for nonocclusive mesenteric ischemia included bowel resection alone (n = 34), interventional radiology (n = 15), or both (n = 15); 27, 10, and 8 patients died, respectively. Seven patients (5.6%) were discharged to home. Among 60 patients without bowel resection or interventional radiology, 50 patients died. In multivariable regression analysis, older age, preoperative hemodialysis, preoperative circulatory support, and hypothermic cardiopulmonary bypass were associated with NOMI. The present study showed that nonocclusive mesenteric ischemia after cardiac surgery was very rare. Mortality following nonocclusive mesenteric ischemia was very high even if patients underwent bowel resection or interventional radiology.

Keywords

Nonocclusive mesenteric ischemia Postoperative complication Cardiac surgery 

Notes

Acknowledgements

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (H30-Policy-Designated-004 and H29-ICT-General-004), and Ministry of Education, Culture, Sports, Science and Technology, Japan (17H04141).

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Clinical Epidemiology and Health Economics, School of Public HealthThe University of TokyoTokyoJapan
  2. 2.Department of SurgeryTokyo Bay Urayasu Ichikawa Medical CenterUrayasuJapan
  3. 3.Department of Health Policy and InformaticsTokyo Medical and Dental University Graduate SchoolTokyoJapan

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