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Predicting In-Hospital Mortality in Acute Mesenteric Ischemia: The RADIAL Score.

Luis Castilla-Guerra1,2, Paula Luque-Linero1, Maria Del Carmen Fernandez-Moreno2,3

  • 1Vascular Risk Unit, Internal Medicine Department, Hospital University Virgen Macarena, 41009 Seville, Spain.

Journal of Clinical Medicine
|February 13, 2026
PubMed
Summary

A new RADIAL score helps predict in-hospital death for patients with acute mesenteric ischemia (AMI). This tool identifies low, intermediate, and high-risk groups, aiding clinical decisions for this critical condition.

Keywords:
acute mesenteric ischemiamortalityprognostic SCORErisk stratification

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Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Critical Care Medicine

Background:

  • Acute mesenteric ischemia (AMI) presents a significant challenge due to high mortality, especially in elderly and comorbid patients.
  • Early risk stratification for AMI is crucial for effective clinical management and decision-making.

Purpose of the Study:

  • To develop and internally validate a prognostic score for predicting in-hospital mortality in patients diagnosed with AMI.

Main Methods:

  • A multicenter, retrospective cohort study involving 693 AMI patients from 10 hospitals.
  • Classification and Regression Trees (CART) identified key variables; logistic regression built the RADIAL score.
  • Receiver operating characteristic (ROC) curve analysis assessed the score's discriminative ability (AUC 0.78).

Main Results:

  • The study included 693 patients with a mean age of 81 years; overall mortality was 62.4%.
  • Key predictors for mortality included hypotension, age > 65, low pH (<7.3), elevated creatinine (>1.7 mg/dL), and absence of rectal bleeding.
  • The derived RADIAL score effectively stratified patients into distinct mortality-risk groups.

Conclusions:

  • The RADIAL score demonstrates strong predictive performance for in-hospital mortality in AMI patients.
  • It categorizes patients into low (30-40%), intermediate (50-60%), and high (80%) risk groups.
  • This validated score can significantly aid clinical decision-making in managing AMI.