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Outcomes of Vasoconstrictor-Induced Non-Occlusive Mesenteric Ischemia of the Colon: A Systematic Review.

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Title: Outcomes of Vasoconstrictor-Induced Non-Occlusive Mesenteric Ischemia of the Colon: A Systematic Review.
Authors: Farooq, Umer1 umer7513781@gmail.com, Alcantar, Daniel2, Ahmed, Zahoor3, Abegunde, Ayokunle T.4
Source: Clinical Medicine & Research. Sep2022, Vol. 20 Issue 3, p164-169. 6p.
Subject Terms: *COLON diseases, *VASOCONSTRICTORS, *LENGTH of stay in hospitals, *SYSTEMATIC reviews, *MANN Whitney U Test, *FISHER exact test, *COCAINE, *DESCRIPTIVE statistics, *MESENTERIC ischemia, *MEDLINE, *DATA analysis software, *DISEASE complications
Abstract: Background: Non-occlusive mesenteric ischemia (NOMI) is due to mesenteric arterial hypoperfusion from several causes, such as hypovolemia, heart failure, shock, vasoconstrictors, and severe liver or renal disease. Vasoconstrictor-induced NOMI is usually iatrogenic or associated with cocaine use. Objectives: Anecdotal reports suggest that cocaine-induced NOMI has the highest mortality among vasoconstrictors. This review aims to compare the outcomes of colonic NOMI secondary to cocaine versus other vasoconstrictors. Methods: We conducted a systematic search of MEDLINE from inception through October 2016 to find articles on colonic NOMI. The study's primary outcomes were mortality and hospital length of stay (LOS), while secondary outcomes included the need for surgery. We reported descriptive statistics as percentages or median and interquartile range (IQR). We compared continuous data with the Mann-Whitney test and categorical data with Fisher's exact test; P<0.05 was statistically significant. Results: Of the 59 studies, 20 case reports and three case series (n=27 patients) met the inclusion criteria. There was no difference in mortality between cocaine-induced NOMI and non-cocaine NOMI (P=1.0). There were statistically significant differences between cocaine and non-cocaine vasoconstrictor-induced colonic NOMI regarding surgery (60% vs 5.8%, P=0.03) and median LOS (7 days vs 4 days, P=0.04). Conclusion: Cocaine-induced NOMI and non-cocaine NOMI both appear to have a relatively high but similar mortality rate, but the former is associated with increased requirement for surgery and LOS; prompt recognition of this clinical entity is required to improve outcomes. [ABSTRACT FROM AUTHOR]
Copyright of Clinical Medicine & Research is the property of Marshfield Clinic and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Outcomes of Vasoconstrictor-Induced Non-Occlusive Mesenteric Ischemia of the Colon: A Systematic Review.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Farooq%2C+Umer%22&quot;&gt;Farooq, Umer&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; umer7513781@gmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Alcantar%2C+Daniel%22&quot;&gt;Alcantar, Daniel&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ahmed%2C+Zahoor%22&quot;&gt;Ahmed, Zahoor&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Abegunde%2C+Ayokunle+T%2E%22&quot;&gt;Abegunde, Ayokunle T.&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Clinical+Medicine+%26+Research%22&quot;&gt;Clinical Medicine &amp; Research&lt;/searchLink&gt;. Sep2022, Vol. 20 Issue 3, p164-169. 6p.
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  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22COLON+diseases%22&quot;&gt;COLON diseases&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22VASOCONSTRICTORS%22&quot;&gt;VASOCONSTRICTORS&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22LENGTH+of+stay+in+hospitals%22&quot;&gt;LENGTH of stay in hospitals&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22SYSTEMATIC+reviews%22&quot;&gt;SYSTEMATIC reviews&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22MANN+Whitney+U+Test%22&quot;&gt;MANN Whitney U Test&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22FISHER+exact+test%22&quot;&gt;FISHER exact test&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22COCAINE%22&quot;&gt;COCAINE&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22DESCRIPTIVE+statistics%22&quot;&gt;DESCRIPTIVE statistics&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22MESENTERIC+ischemia%22&quot;&gt;MESENTERIC ischemia&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22MEDLINE%22&quot;&gt;MEDLINE&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22DATA+analysis+software%22&quot;&gt;DATA analysis software&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22DISEASE+complications%22&quot;&gt;DISEASE complications&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Non-occlusive mesenteric ischemia (NOMI) is due to mesenteric arterial hypoperfusion from several causes, such as hypovolemia, heart failure, shock, vasoconstrictors, and severe liver or renal disease. Vasoconstrictor-induced NOMI is usually iatrogenic or associated with cocaine use. Objectives: Anecdotal reports suggest that cocaine-induced NOMI has the highest mortality among vasoconstrictors. This review aims to compare the outcomes of colonic NOMI secondary to cocaine versus other vasoconstrictors. Methods: We conducted a systematic search of MEDLINE from inception through October 2016 to find articles on colonic NOMI. The study&#39;s primary outcomes were mortality and hospital length of stay (LOS), while secondary outcomes included the need for surgery. We reported descriptive statistics as percentages or median and interquartile range (IQR). We compared continuous data with the Mann-Whitney test and categorical data with Fisher&#39;s exact test; P&lt;0.05 was statistically significant. Results: Of the 59 studies, 20 case reports and three case series (n=27 patients) met the inclusion criteria. There was no difference in mortality between cocaine-induced NOMI and non-cocaine NOMI (P=1.0). There were statistically significant differences between cocaine and non-cocaine vasoconstrictor-induced colonic NOMI regarding surgery (60% vs 5.8%, P=0.03) and median LOS (7 days vs 4 days, P=0.04). Conclusion: Cocaine-induced NOMI and non-cocaine NOMI both appear to have a relatively high but similar mortality rate, but the former is associated with increased requirement for surgery and LOS; prompt recognition of this clinical entity is required to improve outcomes. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: &lt;i&gt;Copyright of Clinical Medicine &amp; Research is the property of Marshfield Clinic and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder&#39;s express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.3121/cmr.2022.1726
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 6
        StartPage: 164
    Subjects:
      – SubjectFull: COLON diseases
        Type: general
      – SubjectFull: VASOCONSTRICTORS
        Type: general
      – SubjectFull: LENGTH of stay in hospitals
        Type: general
      – SubjectFull: SYSTEMATIC reviews
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      – SubjectFull: MANN Whitney U Test
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      – SubjectFull: FISHER exact test
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      – SubjectFull: COCAINE
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      – SubjectFull: DESCRIPTIVE statistics
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      – SubjectFull: MESENTERIC ischemia
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      – SubjectFull: MEDLINE
        Type: general
      – SubjectFull: DATA analysis software
        Type: general
      – SubjectFull: DISEASE complications
        Type: general
    Titles:
      – TitleFull: Outcomes of Vasoconstrictor-Induced Non-Occlusive Mesenteric Ischemia of the Colon: A Systematic Review.
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            NameFull: Alcantar, Daniel
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            – D: 01
              M: 09
              Text: Sep2022
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