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Updated: May 4, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Predictive factors of mortality in patients with acute mesenteric ischemia. A retrospective study
Aim:
The aim of this retrospective study was to evaluate the impact of some risk factors on mortality in patients with Acute mesenteric ischemia (AMI).
Materials And Methods:
From September 2003 to August 2011, 200 patients were operated on for bowel infarction at our unit: 149 were included in the study. For each patient, socio-demographic (gender and age) and clinical data (extent of necrosis, predisposing factors, WBC, LDH, comorbidities) were collected from patients' clinical records.
Results:
Of the 149 patients who underwent surgery, 57 (38.3%) died. A significantly higher mortality was associated with older age (79.9 versus 74.2 years, p < 0.01), higher LDH serum levels (695 versus 636 UI/L, p < 0.01), higher WBC (25.1 versus 22.5 X 103/mm3; p < 0.01), and extent of necrosis (p< 0.01). Otherwise, there was no correlation between comorbidities and mortality. Finally, multivariate analysis confirmed the significantly higher risk of death in patients with right colon and massive small bowel infarction (adjOR= 3.58; 95% CI=1.36-9.42) and intestinal perforation (adjOR=31.1; 95% CI=2.45-395.7).
Discussion:
The results of our study suggest that the contribution of laboratory tests is limited, even if increased indexes of necrosis (such as LDH) associated with neutrophilic leukocytosis and metabolic acidosis, may help in defining diagnosis/ prognosis, though with low accuracy.
Conclusions:
The extent of necrosis and diagnostic delay seem to be the most important prognostic factors even after adjusting for confounding due to age, presence of comorbidities, and laboratory tests (LDH and WBC).
Key Words:
Acute mesenteric ischemia, Mortality, Predictive factors.
Insights
Acute mesenteric ischemia (AMI) mortality is significantly higher in older patients with extensive bowel necrosis. Diagnostic delay and the extent of tissue death are key predictors of survival in AMI patients.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Critical Care Medicine
Background:
- Acute mesenteric ischemia (AMI) is a surgical emergency with high mortality.
- Identifying predictive factors for AMI mortality is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the impact of various risk factors on mortality in patients diagnosed with Acute Mesenteric Ischemia (AMI).
Main Methods:
- Retrospective analysis of 149 patients operated on for bowel infarction between 2003 and 2011.
- Collected socio-demographic and clinical data, including age, gender, extent of necrosis, predisposing factors, WBC, LDH, and comorbidities.
Main Results:
- Mortality rate was 38.3% (57 out of 149 patients).
- Higher mortality correlated with older age, elevated LDH and WBC levels, and extent of necrosis.
- Multivariate analysis identified right colon infarction, massive small bowel infarction, and intestinal perforation as significant risk factors for death.
Conclusions:
- The extent of necrosis and diagnostic delay are the most critical prognostic factors in AMI.
- Laboratory tests like LDH and WBC have limited but supportive roles in diagnosis and prognosis.
- Comorbidities did not show a significant correlation with mortality in this study.
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