Analysis of risk factors affecting in-hospital mortality in patients with acute mesenteric ischemia / 中华消化杂志

ABSTRACT

Objective:To investigate the risk factors affecting in-hospital mortality in patients with acute mesenteric ischemia (AMI).Methods:From January 1, 2014 to June 30, 2022, the clinical data of 67 patients diagnosed with AMI at Renmin Hospital of Wuhan University were retrospectively analyzed, which included basic data (age, gender, past medical history and comorbidities, etc.), laboratory results (white blood cell count (WBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, prothrombin time (PT), etc.), and imaging manifestations (intestinal pneumatosis, intestinal wall thickening, intestinal dilation, ascites). The clinical data of AMI patients who died during hospitalization were compared with that of AMI patients who survived. Binary logistic regression was used to analyze the independent risk factors of in-hospital mortality in patients with AMI. Mann-Whitney U test and chi-square test were used for statistical analysis. Results:Among the 67 patients with AMI, 17 died and 50 survived. There were significant differences between died and survived patients with AMI in age, the proportion of patients with organ failure, WBC, ALT, AST, creatinine, PT, and the proportion of patients with intestinal dilatation and ascites (76 years old(68 years old, 79 years old) vs. 61 years old (50 years old, 74 years old), 12/17 vs.12.0%(6/50), 15.8×10 9/L(13.5×10 9/L, 23.7×10 9/L) vs. 12.1×10 9/L (9.1×10 9/L, 19.4×10 9/L), 32.0 U/L(19.0 U/L, 88.5 U/L) vs. 20.5 U/L(14.8 U/L, 29.0 U/L), 64.0 U/L(33.8 U/L, 117.0 U/L) vs. 26.0 U/L (18.5 U/L, 36.8 U/L), 135.0 μmol/L(61.5 μmol/L, 198.5 μmol/L) vs. 73.5 μmol/L(60.5 μmol/L, 85.0 μmol/L), 13.7 s(12.9 s, 16.3 s) vs. 12.7 s (11.9 s, 13.6 s), 13/17 vs. 38.0%(19/50), 10/17 vs. 24.0% (12/50); Z=3.06, χ2=22.16, Z=2.01, 2.69, 4.08, 2.45 and 2.78, χ2=7.53 and 6.98; P=0.002, <0.001, =0.044, =0.007, <0.001, =0.014, =0.006, =0.006 and =0.008). The results of binary logistic regression analysis showed that age ( OR=1.224, 95% confidence interval 1.011 to 1.482, P=0.038), organ failure ( OR=113.989, 95% confidence interval 1.353 to 9 604.644, P=0.036), and ascites ( OR=348.289, 95% confidence interval 1.676 to 72 357.934, P=0.032) were independent risk factors of in-hospital mortality in AMI patients. Conclusion:Age, organ failure and ascites are independent risk factors of in-hospital mortality in AMI patients.