Clinical and Laboratory Predictive Factors for Mortality in Acute Mesenteric Ischemia: A Single-Center Experience

急性肠系膜缺血死亡率的临床和实验室预测因素:单中心经验

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Abstract

BACKGROUND Acute mesenteric ischemia (AMI) still has high mortality rates despite improvements in diagnosis and treatment. The aim of the present study was to determine the factors affecting mortality and the role of laboratory findings in predicting mortality in patients with an AMI diagnosis who were followed up and treated in our clinic. MATERIAL AND METHODS The study included 46 patients diagnosed with AMI between 2011 and 2019. Patients' data were examined retrospectively. The patients who died and those who were alive were compared. To determine the risk factors for mortality, we examined age, sex, accompanying diseases, clinical features, American Society of Anesthesiologists (ASA) classification, laboratory and radiological findings, symptoms, time delay laparotomy, surgical procedure used, and the etiology of the ischemia. RESULTS Mortality rates were significantly associated with the etiology, ASA classification, and resected intestinal area (P<0.001, P=0.031, and P=0.024, respectively). Mortality rates were significantly higher in the patients who had comorbid diabetes mellitus, cerebrovascular disease, and chronic renal failure (P=0.012, P=0.05, and P=0.05, respectively). Creatinine, urea, lymphocyte-monocyte ratio (LMR), and hemoglobin-albumin-lymphocyte-platelet (HALP) values were significantly different between alive and dead patient groups (P<0.001, P<0.001, P=0.011, and P=0.029, respectively). No significant differences were found for other parameters. CONCLUSIONS Etiology, ASA classification, larger resection area, some accompanying diseases, and the time from diagnosis to surgery appeared to be risk factors for mortality. In addition, high urea, creatinine, low LMR, and low HALP score were associated with mortality.

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