Prediction of the Clinical Outcomes of Sigmoid Volvulus by Abdominal X-Ray: AXIS Classification System
Aim. Early diagnosis and evaluation of the severity of sigmoid volvulus are necessary for management and early intervention. We developed a new predictive classification system for sigmoid volvulus based on X-ray findings. Methods. We retrospectively analyzed 66 patients diagnosed with sigmoid volvu...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/8493235 |
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| author | Rei Ishibashi Ryota Niikura Nobuya Obana Sho Fukuda Mayo Tsuboi Tomonori Aoki Shuntaro Yoshida Atsuo Yamada Yoshihiro Hirata Kazuhiko Koike |
| author_facet | Rei Ishibashi Ryota Niikura Nobuya Obana Sho Fukuda Mayo Tsuboi Tomonori Aoki Shuntaro Yoshida Atsuo Yamada Yoshihiro Hirata Kazuhiko Koike |
| author_sort | Rei Ishibashi |
| collection | DOAJ |
| description | Aim. Early diagnosis and evaluation of the severity of sigmoid volvulus are necessary for management and early intervention. We developed a new predictive classification system for sigmoid volvulus based on X-ray findings. Methods. We retrospectively analyzed 66 patients diagnosed with sigmoid volvulus using the electronic medical records at the Osaki Citizen’s Hospital and the University of Tokyo Hospital from 2008–2015. We classified patients according to the coffee-bean sign mesenteric axis on X-ray (AXIS classification: group A, 0–90°; group B, 90–135°; and group C, >135°). We examined the association between AXIS classification and severe sigmoid volvulus, intestinal necrosis, need for surgery, 30-day mortality, and length of stay using the Cochran–Armitage trend test. Results. In total, 66 patients were analyzed. They had a mean age of 76.9 years, and 47 (71.0%) were male. They were classified into three groups according to the AXIS classification system (group A, 40 patients; group B, 23 patients; and group C, 3 patients). Group C had a significantly higher frequency of severe sigmoid volvulus (100%) compared to group B (30%) and group A (15%). AXIS classification was significantly associated with the severity of sigmoid volvulus (p=0.003), necrosis (p=0.004), and need for surgery (p=0.001), but not with the 30-day mortality or the length of stay. Conclusions. We developed the AXIS classification system to predict the severity of sigmoid volvulus. This new classification system may facilitate triage and therapeutic decision-making for sigmoid volvulus patients. |
| format | Article |
| id | doaj-art-6396f406c63e4bf7837ad5381efc0e6e |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-6396f406c63e4bf7837ad5381efc0e6e2025-02-03T01:07:28ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/84932358493235Prediction of the Clinical Outcomes of Sigmoid Volvulus by Abdominal X-Ray: AXIS Classification SystemRei Ishibashi0Ryota Niikura1Nobuya Obana2Sho Fukuda3Mayo Tsuboi4Tomonori Aoki5Shuntaro Yoshida6Atsuo Yamada7Yoshihiro Hirata8Kazuhiko Koike9Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Gastroenterology, Osaki Citizen’s Hospital, Miyagi, JapanDepartment of Gastroenterology, Osaki Citizen’s Hospital, Miyagi, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanAim. Early diagnosis and evaluation of the severity of sigmoid volvulus are necessary for management and early intervention. We developed a new predictive classification system for sigmoid volvulus based on X-ray findings. Methods. We retrospectively analyzed 66 patients diagnosed with sigmoid volvulus using the electronic medical records at the Osaki Citizen’s Hospital and the University of Tokyo Hospital from 2008–2015. We classified patients according to the coffee-bean sign mesenteric axis on X-ray (AXIS classification: group A, 0–90°; group B, 90–135°; and group C, >135°). We examined the association between AXIS classification and severe sigmoid volvulus, intestinal necrosis, need for surgery, 30-day mortality, and length of stay using the Cochran–Armitage trend test. Results. In total, 66 patients were analyzed. They had a mean age of 76.9 years, and 47 (71.0%) were male. They were classified into three groups according to the AXIS classification system (group A, 40 patients; group B, 23 patients; and group C, 3 patients). Group C had a significantly higher frequency of severe sigmoid volvulus (100%) compared to group B (30%) and group A (15%). AXIS classification was significantly associated with the severity of sigmoid volvulus (p=0.003), necrosis (p=0.004), and need for surgery (p=0.001), but not with the 30-day mortality or the length of stay. Conclusions. We developed the AXIS classification system to predict the severity of sigmoid volvulus. This new classification system may facilitate triage and therapeutic decision-making for sigmoid volvulus patients.http://dx.doi.org/10.1155/2018/8493235 |
| spellingShingle | Rei Ishibashi Ryota Niikura Nobuya Obana Sho Fukuda Mayo Tsuboi Tomonori Aoki Shuntaro Yoshida Atsuo Yamada Yoshihiro Hirata Kazuhiko Koike Prediction of the Clinical Outcomes of Sigmoid Volvulus by Abdominal X-Ray: AXIS Classification System Gastroenterology Research and Practice |
| title | Prediction of the Clinical Outcomes of Sigmoid Volvulus by Abdominal X-Ray: AXIS Classification System |
| title_full | Prediction of the Clinical Outcomes of Sigmoid Volvulus by Abdominal X-Ray: AXIS Classification System |
| title_fullStr | Prediction of the Clinical Outcomes of Sigmoid Volvulus by Abdominal X-Ray: AXIS Classification System |
| title_full_unstemmed | Prediction of the Clinical Outcomes of Sigmoid Volvulus by Abdominal X-Ray: AXIS Classification System |
| title_short | Prediction of the Clinical Outcomes of Sigmoid Volvulus by Abdominal X-Ray: AXIS Classification System |
| title_sort | prediction of the clinical outcomes of sigmoid volvulus by abdominal x ray axis classification system |
| url | http://dx.doi.org/10.1155/2018/8493235 |
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