Risk Factors for 30-day Mortality After Emergency Surgery for Non-occlusive Mesenteric Ischemia

Non-occlusive mesenteric ischemia (NOMI) is a rare and highly fatal disease characterized by intestinal ischemia or necrosis despite the absence of obstruction of the mesenteric vessels. This research aimed to investigate the risk factors for 30-day mortality of NOMI after emergency surgery. We analyzed 42 consecutive patients who underwent emergency surgery for NOMI from April 2015 to August 2022. Patients were divided into two groups, based on 30-day postoperative survival as follows: early death (30-day mortality group, n=9) and survival (survivor group, n=33). The characteristics, past history, and surgical outcomes were compared between the groups. The 30-day mortality rate was 21.4%. There were no significant differences in the patients' characteristics and surgical complications between groups. However, the 30-day mortality group had a significantly higher number of patients with chronic kidney disease (CKD) (p<0.01) and on hemodialysis (p=0.01), as well as a significantly lower platelet count (p=0.02). In the multivariate analysis, a preoperative lactate dehydrogenase >1,127 U/l was identified as an independent risk factor for 30-day mortality following emergency surgery for NOMI (odds ratio=23.6; 95% confidence interval=2.12-262.9; p=0.01). CKD, hemodialysis, high LDH, and low platelet count were found to be risk factors for early mortality from NOMI.