[Prognostic factors for hospital mortality in patients with acute mesenteric ischemia who undergo intestinal resection due to necrosis].
BACKGROUND
The purpose of this study was to review our experience in patients with acute mesenteric ischemia (AMI) and to identify prognostic factors associated with hospital mortality.


METHODS
Clinical data of patients with AMI were reviewed and analyzed retrospectively. A total of 67 patients (34 female, overall mean age 66 years) were evaluated in the study.


RESULTS
Small bowel necrosis was detected in all patients, while colonic involvement was present in 21 (31.3%). Necrosed small bowels were resected in 59 (88%) in the first intervention. Embolectomy was also performed in 2 (3%) of these cases. Anastomosis was established in 22 (32.8%). Second-look operation was performed in 31 (46.3%) and primary resection and re-resection were performed in 8 (11.9%) and 11 (16.4%) patients, respectively. Hospital mortality rate was 56.7% (n=38). Logistic regression analysis showed prolonged symptom duration (>24h) (p=0.000), sepsis (p=0.022) and colonic necrosis accompanied with small bowel necrosis (p=0.002) as the independent prognostic factors in hospital mortality.


CONCLUSIONS
AMI has a high hospital mortality rate due to late diagnosis and sepsis. Another risk factor is colonic involvement. Early evaluation in high-risk patients and resection for necrosed intestinal segments as soon as possible prior to sepsis may reduce the hospital mortality rate.
Unalp
Haluk Recai
HR
Department of 4th General Surgery, Atatürk Training and Research Hospital, Izmir, Turkey. drhru@mynet.com
Atahan
Kemal
K
Kamer
Erdinç
E
Yaşa
Haydar
H
Tarcan
Ercüment
E
Onal
Mehmet Ali
MA
D000208:Acute Disease; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000401:mortality* / Q000601:surgery; D016015:Logistic Models; D008297:Male; D009336:Necrosis / Q000150:complications* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis