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Natural History of Mesenteric Venous Thrombosis: A Large Multicentre Study

2008· article· en· W2594507558 on OpenAlexaff
Francesco Dentali, Walter Ageno, Dan Witt, Alessandra Malato, Nathan P. Clark, David García, Sergio Siragusa, Kathleen H. McCool, S. Van Dyke, Mark Crowther

Bibliographic record

VenueBlood · 2008
Typearticle
Languageen
FieldMedicine
TopicVascular anomalies and interventions
Canadian institutionsSt. Joseph’s Healthcare HamiltonMcMaster UniversitySt. Joseph's Hospital
Fundersnot available
KeywordsMedicineNatural historyThrombosisSurgeryLaparotomyAnticoagulantMortality rateMesenteric VeinSplanchnic CirculationCohortInternal medicineSplanchnic

Abstract

fetched live from OpenAlex

Abstract Introduction: Mesenteric venous thrombosis (MVT) is an uncommon but potentially life-threatening disease, accounting for 5–15% of mesenteric ischemic events. Most cases of MVT are either identified at laparotomy or at autopsy, with a mortality rate of approximately 50% in old series. Advances in imaging techniques have facilitated the early diagnosis of MVT and, thus, have contributed to a decrease in mortality in the more recent series. The treatment of MVT involves anticoagulation alone or in combination with surgery. Experts suggest that MVT can safely be managed without surgery if there is no evidence of bowel infarction. However, information on the natural history of MVT and on efficacy and safety of long term treatment with oral anticoagulant (OAT) is based on small uncontrolled series of patients with a limited follow up. Therefore, the aim of our study is to clarify the natural history of this disease in a large cohort of patients recently diagnosed with MVT. Methods: The charts of all patients with splanchnic vein thrombosis who are currently attending or who have attended four anticoagulation clinics (Denver, Albuquerque, Varese and Palermo) were reviewed. At these centres, patients are regularly followed up for the monitoring of OAT and information on clinical events is documented and registered in a computerized database. All patients with objectively diagnosed MVT, were selected. The charts of eligible patients were reviewed for baseline clinical characteristics including sex, age, prior history of cardiovascular disease and use and type of anticoagulant therapy. Information on mortality and all objectively confirmed recurrent venous thromboembolic events were noted. Results: Seventy seven patients (mean age 49.2 years; 45 males) were included. Thirteen patients had a previous thromboembolic event. Thirty two were idiopathic. Forty six patients were on long term OAT. Median follow up was 36 months (Range 2–204 months). Seven patients had a recurrent thromboembolic event (5 splancnic vein thromboses and two PEs) for an incidence rate of 23.4 events/1000 year patient. Two patients (2.6%) had a major bleeding event (one subdural haematoma and one gastroenteric bleeding). Five patients had a VTE recurrence when suspended OAT for an incidence rate of 45.9 events/1000 year patient. Seven patients (9.1%) died during follow up (4 were related to cancer). Conclusion: patients with a previous episode of MVT have a low risk of recurrent thromboembolic events while on oral anticoagulant treatment. This risk is clearly increased after treatment is stopped. In these patients, long term anticoagulant therapy appears as a safe and effective option.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.160
Threshold uncertainty score0.316

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.027
GPT teacher head0.268
Teacher spread0.242 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2008
Admission routes1
Has abstractyes

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