Mortality in Acute Arterial Mesenteric Ischemia: A Single-Center Experience

Abstract

Abstract Background : Acute mesenteric ischemia (AMI) is a life-threatening pathology that often requires urgent surgical intervention. It is frequently faced in elderly patients. Despite advances in the diagnosis of AMI morbidity, and mortality rates are still high. The presence of comorbidities delayed surgical intervention due to diagnostic difficulties, and in most cases, older patients with heart problems may be remarkable factors for higher mortality rates. Diagnostic challenges are tried to be overcome with both imaging methods and laboratory findings. Unfortunately, to date, no clear laboratory parameters have been described in diagnosing or predicting mortality of mesenteric ischemia. Materials and Methods : The patients diagnosed with acute arterial mesenteric ischemia between the dates 2010-2019 were enrolled in the study. Demographic characteristics, diagnostic biochemical parameters (lymphocyte, neutrophil, albumin, C-reactive protein, lactate, lactate dehydrogenase, Di-Dimer, troponin, white blood count, platelet, fibrinogen, creatine kinase-MB) levels, as well as comorbidities of the patients, were evaluated. Results : A total of 149 patients was enrolled in the study, with a mean age of 66.11 . In the non-survivor group, neutrophil, RDW, lactate, DDM, Fibrinogen, and CK-MB levels, furthermore albumin levels were defined as significantly elevated in the survivor group (p0.05). Hypertension was the major comorbidity by far in both groups. Conclusion : High levels of fibrinogen, lactate, DDM, CK-MB levels and low levels of albumin levels may be predictors of mortality in mesenteric ischemia.

Keywords

• Mesenteric ischemia, Mortality, Predictive factors

Akut Arteryel Mezenterik İskemide Mortalite: Tek Merkez Deneyimi

Abstract

Özet Amaç : Akut mezenterik iskemi (AMI), sıklıkla acil cerrahi müdahale gerektiren hayatı tehdit eden bir patolojidir. Yaşlı hastalarda sıklıkla karşılaşılmaktadır. AMI tanısındaki gelişmelere rağmen morbidite ve mortalite oranları hala yüksektir. Komorbiditelerin varlığı, tanısal zorluklar nedeniyle cerrahi müdahaleyi geciktirir ve genellikle kardiyak problemleri olan yaşlı hastalar, daha mortal seyredebilirler. Gerek görüntüleme yöntemleri gerekse laboratuvar bulguları ile tanısal zorluklar aşılmaya çalışılmaktadır. Günümüzde halen mezenterik iskeminin mortalitesini teşhis etmek veya tahmin etmek için net bir laboratuvar parametresi tanımlanmamıştır. Gereç-Yöntemler : 2010-2019 tarihleri arasında akut arteriyel mezenterik iskemi tanısı alan hastalar çalışmaya dahil edildi. Demografik özellikler, tanısal biyokimyasal parametreler (lenfosit, nötrofil, albümin, C-reaktif protein, laktat, laktat dehidrojenaz, D-Dimer, troponin, beyaz kan sayımı, trombosit, fibrinojen, kreatin kinaz-MB) seviyeleri ve ayrıca komorbiditeler değerlendirildi. Bulgular : Çalışmaya yaş ortalaması 66.11 olan toplam 149 hasta alındı. Mortal seyirli grupta nötrofil, RDW, laktat, DDM, Fibrinojen ve CK-MB seviyeleri, ayrıca albümin seviyeleri hayatta kalan grupta anlamlı olarak yüksek olarak tanımlandı (p < 0.05). Her iki grupta da açık ara en önemli komorbidite hipertansiyondu. Sonuç : Yüksek fibrinojen, laktat, DDM, CK-MB seviyeleri ve düşük albümin seviyeleri mezenterik iskemide mortaliteyi saptamada prediktif faktörler olabilirler.

Keywords

• Mezenterik iskemi
• Mortalite
• Prediktif faktörler

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