Identification of Prognostic Factors for In-Hospital Mortality in Acute Mesenteric Ischemia.
- Author:
Ji Ho PARK
1
;
Sang Ho JEONG
;
Seung Jin KWAG
;
Tae Jin PARK
;
Chi Young JEONG
;
Young Tae JU
;
Eun Jung JUNG
;
Soon Chan HONG
;
Sang Kyung CHOI
;
Woo Song HA
;
Young Joon LEE
Author Information
1. Department of Surgery, Gyeongsang National University, Post-graduate School of Medicine, Jinju, Korea. orangejulia@naver.com
- Publication Type:Original Article
- Keywords:
Mesenteric vascular disease;
Ischemia;
Hospital mortality;
Prognosis
- MeSH:
APACHE;
Aspartate Aminotransferases;
Bilirubin;
Blood Urea Nitrogen;
Creatinine;
Glucose;
Hospital Mortality;
Humans;
Hydrogen-Ion Concentration;
Hyperglycemia;
Ischemia;
Lipase;
Multivariate Analysis;
Partial Thromboplastin Time;
Prognosis;
Prothrombin;
Retrospective Studies;
Shock;
Vascular Diseases
- From:Journal of the Korean Society for Vascular Surgery
2012;28(3):133-141
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to determine the prognostic factors and risk scorings that could have an impact on the in-hospital mortality of acute mesenteric ischemia (AMI). METHODS: Forty consecutive patients received an operation due to AMI between January 2001 and June 2009. The hospital medical charts and clinical records were retrospectively reviewed. Clinical features, laboratory findings, operative findings, surgical procedure, and prognostic scoring system were collected and assessed as possible the prognostic factors for in-hospital mortality. RESULTS: The overall hospital mortality rate was 32.5% (13/40). In a univariate analysis, significant predictors of in-hospital mortality were decreased mentality (P=0.029), shock at admission (P=0.006), symptom duration (P=0.011), blood urea nitrogen (P=0.029), serum creatinine (P<0.001), glucose (P=0.004), total bilirubin (P=0.044), aspartate aminotransferase (P=0.001), lipase (P=0.039), pH (P=0.014), bicarbonate (P=0.027), prothrombin time-international normalized ratio (P=0.006), activated partial thromboplastin time (P=0.004), length of remnant bowel (P=0.008), postoperative inotropics (P=0.007), Acute Physiology and Chronic Health Evaluation II (P=0.009), and American Society of Anesthesiologists (ASA) grading (P=0.005). In a multivariate analysis, the variables hyperglycemia (P=0.013) and higher ASA (>II) (P=0.02) were identified as independent prognostic factors of in-hospital mortality. CONCLUSION: In conclusion, the prognostic factors in AMI who have hyperglycemia (>200 mg/dL) and high ASA grading (>II) are truly associated with very high in-hospital mortality.