Factors that may affect the outcome of acute occlusive mesenteric ischemia. A single-center study

Qian Zhang1, Tianyi Ma1, Hongwei Zhao1

  • 1Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, 102218, China.

BMC Surgery
|January 13, 2024
PubMed
Abstract

Insights

Acute occlusive mesenteric ischemia patients with elevated creatine kinase isoenzyme or prolonged surgical time face higher complication risks. Early identification of these factors is crucial for improving patient outcomes in this rare but serious condition.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Critical Care Medicine

Background:

  • Acute mesenteric ischemia (AMI) is a rare, life-threatening condition involving the blockage of blood supply to the intestines.
  • Acute occlusive mesenteric ischemia encompasses mesenteric artery embolism, thrombosis, and mesenteric vein thrombosis.

Purpose of the Study:

  • To identify factors influencing outcomes in patients with acute occlusive mesenteric ischemia.
  • To investigate predictors of complications within six months following initial treatment.

Main Methods:

  • Retrospective review of 59 acute occlusive mesenteric ischemia patients admitted between May 2016 and May 2022.
  • Patients were categorized based on the occurrence of complications (Clavien–Dindo ≥ 2) within six months.
  • Analysis included demographics, clinical signs, laboratory results, CT angiography findings, management strategies, and outcomes.

Main Results:

  • Seventeen out of 59 patients developed significant complications.
  • Factors like transmural intestinal necrosis, peritonitis, elevated white blood cell count, neutrophil percentage, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, creatine kinase isoenzyme, cardiac troponin I, and surgical time differed significantly between groups.
  • Creatine kinase isoenzyme (OR=1.415) and surgical time (OR=1.014) were identified as independent risk factors for complications.

Conclusions:

  • Patients with acute occlusive mesenteric ischemia and a creatine kinase isoenzyme level > 2.22 ng/mL are at increased risk of complications.
  • A surgical duration exceeding 156 minutes is also associated with a higher likelihood of post-admission complications.
  • These findings highlight key indicators for predicting adverse outcomes in AMI patients.

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