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Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Background

It is difficult to accurately determine whether emergent patients with small-bowel obstruction (SBO) have small-bowel ischemia and necrosis (SBIN). Therefore, in this study, we aimed to assess the ability of abdominal CT scans to predict SBIN and establish a new predictive model.

Methods

From March 2018 to May 2023, a rigorous posthoc analysis was conducted on whether 177 emergent patients with SBO had SBIN. Four clinical indexes and 19 CT signs were analyzed, and a multivariate scoring model for predicting SBIN was established using logistic regression analysis. A receiver operating characteristic (ROC) curve was used to assess the accuracy of this model.

Results

Multivariate analysis showed that mesenteric edema and effusion (OR=23.450), significant thickening and the target sign on the small-bowel wall on plain scans (OR=23.652), significant thinning of the small-bowel wall (OR=30.439), significant decrease in small-bowel wall density (OR=12.885), and significant increase in small-bowel wall density (OR=19.550) were significantly correlated with SBIN (P<0.05). According to their multivariate ORs, an appropriate “predictive score” was assigned to each sign, and the rates of SBIN among those with a total score of 0-4, 5-6, and 7-8 were 2.2%, 86.4%, and 96.9%, respectively. The AUC of this predictive scoring model for SBIN exceeded 0.980.

Conclusion

We have developed a predictive scoring model for SBIN, for which the incidence of SBIN increases with increasing predictive scores. This model can be useful for clinical treatment.

© 2024 The Author(s). Published by Bentham Open.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2024-01-01
2024-11-23

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/content/journals/cmir/10.2174/1573405620666230801105613
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Multivariate Prediction of Small-bowel Ischemia and Necrosis using CT in Emergent Patients with Small-bowel Obstruction
Curr. Med. Imaging 20, E010823219331 (2024); https://doi.org/10.2174/1573405620666230801105613
/content/journals/cmir/10.2174/1573405620666230801105613
/content/journals/cmir/10.2174/1573405620666230801105613
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  • Article Type:     Research Article
Keyword(s): CT; Ischemia and Necrosis; Multivariate prediction; ROC; Small-bowel obstruction

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