Factors influencing mortality of acute intestinal infarction associated with SIRS.

OBJECTIVE

In patients with acute mesenteric ischemia, early diagnosis is considered to improve the prognosis by preventing the occurrence of systemic inflammatory response syndrome (SIRS). However, it remains unclear which factors affect the mortality once advanced ischemia and SIRS develop in cases of delayed diagnosis. The aim of this study was to investigate the predictors of in-hospital mortality in the late stage of acute mesenteric ischemia.

METHODS

We retrospectively studied 66 consecutive patients who had acute intestinal infarction associated with SIRS between 1986 and 2002. They included 19 of acute mesenteric thromboembolism and 47 cases of postoperative adhesions or an incarcerated hernia. A multivariate logistic model was used to identify important factors for in-hospital death among the background data. Two models were constructed with/without the cause of intestinal obstruction as a variable, since it might affect the prognosis.

RESULTS

The results suggested that concomitant cardiac morbidity, high serum amylase level, and thrombocythemia are important factors for in-hospital mortality of acute intestinal infarction, regardless of the cause of intestinal infarction.

CONCLUSIONS

Our results indicated that the prognosis is strongly influenced by associated cardiac morbidity and abnormal coagulopathy in the advanced stage of mesenteric ischemia.