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Journal of critical care · Dec 2017
Review Meta AnalysisRisk factors for postoperative acute mesenteric ischemia among adult patients undergoing cardiac surgery: A systematic review and meta-analysis.
- Qi-Wen Deng, Wen-Cheng Tan, Bing-Cheng Zhao, Wen-Tao Deng, Miao Xu, Wei-Feng Liu, and Ke-Xuan Liu.
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou 510515, China; Department of Anesthesiology, The First Affiliated Hospital, Sun Yet-sen University, No.58, Zhongshan 2nd Road, Guangzhou 510080, China. Electronic address: dengqiwen0315@163.com.
- J Crit Care. 2017 Dec 1; 42: 294-303.
PurposeWe aimed to seek risk factors for AMI among adult patients undergoing cardiac surgery.Materials And MethodsWe searched electronic bibliographic databases for studies reporting risk factors for AMI among adult patients undergoing cardiac surgery. Pooled odds ratios (OR) and standard mean differences (SMD or MD) for risk factors between AMI and control group were estimated.Results11 studies with 67,195 patients met the inclusion criteria. 14 risk factors were found to be statistically significant: preoperative factors including age (MD 4.62years, 95% CI (1.97,7.27)), cardiac shock (OR 5.17, (1.17,22.81)), peripheral vascular disease (OR 3.53, (2.05,6.09)), need for intra-aortic balloon pump (IABP) (OR 5.89, (3.26,10.65)), emergency surgery (OR 3.75, (1.69,8.33)), and postoperative factors including atrial fibrillation (OR 2.41, (1.79,3.24)), CK-MB level (SMD 1.06, (0.62 to 1.50)), serum creatinine >200μmol/L (OR 23.39, (11.61,47.12)), blood loss (MD 358.32mL, (53.56,663.07)), prolonged ventilation (OR 9.04, (5.24,15.62)), need for IABP (OR 6.32, (3.19,12.54)), inotropic treatment (OR 8.40, (3.19,22.14)), blood transfusion (OR 9.15, (4.79,17.48)), reoperation (OR 3.30, (1.55,7.04)).Conclusions14 risk factors were associated with an increased risk of AMI, which indicated that AMI might occur via stenosis or occlusion of mesenteric vessels, reduced blood volume or maldistribution of blood flow.Copyright © 2017. Published by Elsevier Inc.
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