Previous cardiac illness (P=0.045), elevated urea (P<0.001), and bowel involvement independently increased perioperative mortality in acute mesenteric ischemia, while intestinal resection was protective (P<0.001).
Observational (n=132)
No
Previous cardiac illness, acute renal failure (elevated urea), and large bowel ischemia are independent risk factors for perioperative mortality in patients undergoing surgery for acute mesenteric ischemia.
INTRODUCTION: Acute intestinal ischemia is in most cases a lethal condition with a low survival rate. Risk factors of perioperative mortality are poorly defined. The aim of this study was to define risk factors that predict an adverse outcome of acute mesenteric ischemia (AMI). METHODS: A total of 132 consecutive patients (73 men, 59 women), mean+/-SD age 71.96+/-13.64 years, who underwent surgery because of AMI in a university tertiary care center were evaluated over a period of 10 years. Clinical features, laboratory findings, etiologic factors, and surgical procedures were recorded and assessed as possible risk factors for perioperative mortality. RESULTS: Of 132 patients, 86 (65.2%) died during the perioperative period as a direct result of AMI. Significant univariate predictors of perioperative mortality were age (P=0.01), cardiopathy (P=0.002), digoxin intake (P=0.015), shock (P=0.01), urea plasma level (Por=2.48 mmol/L (P=0.035); time delay to surgery (P=0.023); colonic involvement (P<0.001); small and large bowel involvement (P<0.001); arterial versus venous ischemia (P=0.007); and intestinal resection (P<0.001). In the multivariate analysis, the variables previous cardiac illness (P=0.045), urea plasma levels (P<0.001), and small and large bowel involvement were identified as independent risk factors of perioperative mortality. Intestinal resection (P<0.001) was a favorable predictor. CONCLUSIONS: Age, time delay to surgery, shock, and acidosis significantly increase the risk of mortality due to AMI, whereas intestinal resection has a protective effect. However, only previous cardiac illness, acute renal failure, and large bowel ischemia have a negative effect as independent risk factors of mortality of AMI.
Acosta‐Mérida et al. (Sat,) conducted a observational in Acute mesenteric ischemia (n=132). Clinical and laboratory risk factors (e.g., previous cardiac illness, elevated urea, bowel involvement) vs. Absence of respective risk factors was evaluated on Perioperative mortality. Previous cardiac illness (P=0.045), elevated urea (P<0.001), and bowel involvement independently increased perioperative mortality in acute mesenteric ischemia, while intestinal resection was protective (P<0.001).