Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2020; 26(26): 3800-3813
Published online Jul 14, 2020. doi: 10.3748/wjg.v26.i26.3800
Nomogram for predicting transmural bowel infarction in patients with acute superior mesenteric venous thrombosis
Meng Jiang, Chang-Li Li, Chun-Qiu Pan, Wen-Zhi Lv, Yu-Fei Ren, Xin-Wu Cui, Christoph F Dietrich
Meng Jiang, Xin-Wu Cui, Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Chang-Li Li, Department of Geratology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan 430015, Hubei Province, China
Chun-Qiu Pan, Department of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Wen-Zhi Lv, Department of Artificial Intelligence, Julei Technology Company, Wuhan 430030, Hubei Province, China
Yu-Fei Ren, Department of Computer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Christoph F Dietrich, Department of Internal Medicine, Hirslanden Clinic, Berne 27804, Switzerland
Author contributions: Jiang M, Cui XW and Li CL designed the study; Ren YF and Cui XW supervised the study; Jiang M, Pan CQ and Lv WZ collected and analyzed the data; Ren YF performed the R Script; Jiang M prepared the figures and tables, and drafted the manuscript; Dietrich CF revised the manuscript for important intellectual content; Ren YF and Cui XW contributed equally as co-corresponding authors.
Supported by Wuhan Tongji Hospital, No. 2017A002; and Wuhan Science and Technology Bureau, No. 2017060201010181.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Tongji Medical college, Huazhong University of Science and Technology.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xin-Wu Cui, MD, PhD, Professor, Deputy Director, Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan 430030, Hubei Province, China. cuixinwu@live.cn
Received: February 25, 2020
Peer-review started: February 25, 2020
First decision: May 22, 2020
Revised: May 23, 2020
Accepted: June 5, 2020
Article in press: June 5, 2020
Published online: July 14, 2020
Processing time: 140 Days and 4.6 Hours
Core Tip

Core tip: The high mortality rate of acute superior mesenteric venous thrombosis is closely associated with the occurrence of transmural bowel infarction (TBI). Early detection and subsequent resection of irreversible necrotic intestine before sepsis and multi-organ failure could improve the functional outcome of the small bowel and patient prognosis. We found that the decreased bowel wall enhancement, rebound tenderness, serum lactate levels > 2 mmol/L and previous history of deep venous thrombosis independently predicted TBI. A nomogram that incorporated these four risk factors achieved an area under the receiver operator characteristic curve of 0.860 and 0.851 in the training and validation cohort, respectively, with good calibration. The nomogram can be conveniently used to facilitate the individualized prediction of TBI in patients with acute mesenteric ischemia.