Abstract
IntroductionWe investigated prognostic parameters of patients who underwent surgical intervention for acute mesenteric ischemia by evaluating demographic characteristics and laboratory data on admission.MethodsThe hospital records of 30 patients who underwent surgical interventions due to acute mesenteric ischemia between January 2008 and December 2012, were reviewed retrospectively. The records were investigated with regard to demographic data, the presence of co-morbid diseases, presenting complaints, time elapsed between symptom onset and hospital admission, laboratory findings at admission, findings at surgical exploration, surgical methods used, and treatment outcomes. The patients were divided into two groups, according to death (Group 1) or survival (Group 2), and the two groups were compared in terms of the specified parameters.ResultsOf the patients, 15 were male (50%) and 15 female (50%); their mean age was 71.4 (29–94) years. Abdominal pain was the chief complaint in all patients (100%) and mean time from pain onset to hospital admission was 21 (1–72) h. In abdominal exploration, total small bowel (SB) ischemia and necrosis was found in 6 (20%) patients and other patients had subtotal SB, segmental SB, segmental SB with colon, or isolated colon ischemia. Treatment in 15 patients (50%) ended in mortality. Mean age (p = 0.038), urea (p = 0.002), AST (p < 0.001), ALT (p < 0.001), mean platelet volume (MPV; p = 0.002), and amylase (p = 0.022) levels in Group 1 were significantly higher versus Group 2, whereas Ca (p = 0.024) and albumin (p = 0.002) levels were significantly lower.ConclusionsIn this study, unlike other parameters that have been shown to be of prognostic significance in mesenteric ischemia, MPV values at presentation were higher among non-survivors than survivors.
Highlights
We investigated prognostic parameters of patients who underwent surgical intervention for acute mesenteric ischemia by evaluating demographic characteristics and laboratory data on admission
Non-occlusive mesenteric ischemia is caused by conditions such as hypovolemia, sepsis, and cardiogenic shock, whereas the underlying cause of ischemia in 70–80% of cases with Acute mesenteric ischemia (AMI) is the occlusion of the superior mesenteric artery, caused by embolism or thrombosis [1]
If it is impossible to diagnose AMI in the early period in most patients, it becomes more important that parameters be determined that would be useful to predict the disease course at the time of diagnosis
Summary
We investigated prognostic parameters of patients who underwent surgical intervention for acute mesenteric ischemia by evaluating demographic characteristics and laboratory data on admission. The most important causes of the high mortality include delayed presentation, non-specific clinical findings, lack of simple biochemical parameters that could be routinely used to diagnose the condition early, and time loss while performing tests for differential diagnosis in patients who are not immediately suspected to have AMI at presentation [3]. The aim of the present study was to evaluate the outcomes of surgical treatment over a period of 5 years in patients who underwent surgery with a diagnosis of AMI and to investigate the parameters of prognostic significance If it is impossible to diagnose AMI in the early period in most patients, it becomes more important that parameters be determined that would be useful to predict the disease course at the time of diagnosis.
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