Prognostic Markers for Early Mortality in Acute Mesenteric Ischemia

Acute mesenteric ischemia (AMI) is a high-mortality vascular emergency caused by impaired intestinal perfusion due to embolic or thrombotic obstruction. Reliable biomarkers are needed for early diagnosis and prognostic evaluation. This study aimed to investigate the value of the lactate dehydrogenase/albumin ratio (LAR) in predicting 28-day mortality in AMI patients and to compare its prognostic performance with other inflammatory markers.

This retrospective cohort study included 129 adult patients diagnosed with AMI by contrast-enhanced computed tomography angiography. Patients were divided into survivors and non-survivors according to 28-day outcomes. LAR, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and CRP/albumin ratio (CAR) were calculated, and prognostic factors associated with mortality were analyzed.

34.1% of patients (n=44) died within 28 days. Mean age, LAR, lactate, NLR, and PLR were significantly higher in the mortality group (p<0.001). In the ROC analysis, LAR had the highest discriminatory power in predicting 28-day mortality (AUC=0.820; 95% CI: 0.758-0.883; p<0.001). The optimal threshold of 9.9 yielded 71.1% sensitivity and 90.9% specificity.

LAR is a strong prognostic marker for 28-day mortality in AMI patients and may support risk stratification and treatment management using routine laboratory parameters.