Prognostic factors in acute mesenteric ischemia

ABSTRACT

The objective of the study was to explore the prognostic factors by comparing survivor from non-survivor group with the diagnosis of acute mesenteric ischemia. This study was conducted at the Aga Khan University Hospital, Karachi over six and half years. Eighteen patients were hospitalized with the diagnosis of acute mesenteric ischemia [AMI]. Survivor and non-survivor groups had 8 and 10 patients respectively, giving the overall mortality rate of 56%. The surviving patients had significantly shorter length of bowel necrosis, i.e. 176 cm [mean] compared to 525cm [mean] in non-survivor group [P-value 0.0003]. The surviving patients also had less number of "re-look" laparotomies as compared to non-survival group; mean 1.1 and 2 respectively [P-value 0.0002]. The higher number of "re-look" laparotomies were attributed to incorrect visual determination of bowel viability at the time of first laparotomy. The duration of symptoms and interval between arrival to hospital and operation were not different between the two groups [P values 0.98 and 0.65 respectively]. Length of bowel necrosis and number of surgical procedures are the prognostic factors in acute mesenteric ischemia. Comparing the two groups also showed that difference in age, sex and symptoms were insignificant