Table 2 Comparison of arterial AMI according to 30-day outcome
From: Prognostic factors of acute mesenteric ischemia in ICU patients
Characteristics | Total (n = 214) | Survivors (n = 69) | Non survivors (n = 145) | p- value |
|---|---|---|---|---|
Demographics | ||||
Gender, male (%) | 51 | 55 | 49 | 0.46 |
Age at diagnosis (years) (mean ± SD) | 72 ± 13 | 72 ± 14 | 70 ± 13 | 0.16 |
Length of in-hospital stay (days) (median [IQR]) | 13 [5–30] | 33 [16–78] | 7 [3–19] | < 0.001 |
Reason for ICU admission | ||||
Main admission diagnosis (%) | 42 | 71 | 28 | < 0.001 |
Surgical reason (%) | 52 | 76 | 38 | < 0.001 |
Urgent reason (%) | 90 | 88 | 90 | 0.66 |
Aortic surgery (%) | 17 | 25 | 14 | 0.050 |
PMH and comorbidities | ||||
Arterial hypertension (%) | 69 | 81 | 63 | 0.001 |
Hypercholesterolemia (%) | 47 | 47 | 46 | 0.93 |
Diabetes (%) | 20 | 15 | 23 | 0.16 |
Cardiomyopathy (%) | 57 | 63 | 55 | 0.23 |
PMH of atrial fibrillation (%) | 26 | 32 | 24 | 0.23 |
Peripheral artery disease (%) | 44 | 49 | 41 | 0.32 |
PMH of cancer (%) | 28 | 21 | 32 | 0.08 |
Chronic inflammatory disease (%) | 18 | 18 | 17 | 0.91 |
Hypercoagulable state (%) | 6 | 6 | 6 | 0.99 |
PMH of surgery (%) | 78 | 74 | 80 | 0.3 |
Laboratory findings | ||||
CRP (mg/dl) (median [IQR]) | 18 [8–25] | 17 [6–24] | 19 [8–28] | 0.24 |
Serum creatinine (mg/dl) (median [IQR]) | 2 [1.2–3] | 1.6 [1.1–2.8] | 2.1 [1.3–3.1] | 0.014 |
LDH > 250 IU/l (%) | 72 | 58 | 78 | 0.02 |
Leukocytes (×103/mm3) (median [IQR]) | 14.8 [8.8–22] | 13 [7.4–20.3] | 14.8 [9.5–21.5] | 0.22 |
Neutrophils (× 103/mm3) (median [IQR]) | 12.6 [6.6–18] | 10.7 [6.2–18.1] | 12.7 [6.9–18.2] | 0.54 |
Lymphocytes (×103/mm3) (median [IQR]) | 0.83 [0.5–1.18] | 0.9 [0.55–1.14] | 0.8 [0.54–1.24] | 0.73 |
NLR (median [IQR]) | 14 [7.7–24] | 10.4 [7.8–20.1] | 14 [7.5–25.8] | 0.36 |
INR (median [IQR]) | 1.4 [1.1–1.9] | 1.2 [1.1–1.4] | 1.4 [1.2–2] | < 0.001 |
Platelets 24 h before diagnosis (×103/mm3) (median [IQR]) | 167 [88–277] | 183 [103–263] | 155 [79–269] | 0.35 |
Platelets < 100,000/mm3 after diagnosis (%) | 59 | 36 | 69 | < 0.001 |
Arterial lactate at diagnosis (mmol/l) (median [IQR]) | 3.6 [2–7.5] | 2.5 [1.4–3.8] | 4.4 [2.6–9.4] | < 0.001 |
Arterial lactate 24 h after diagnosis (mmol/l) (median [IQR]) | 3.4 [1.7–8.7] | 1.7 [1.3–2.3] | 7.9 [3.3–15.4] | < 0.001 |
Time from ICU admission to diagnosis (days) (median [IQR]) | 1 [0–4] | 0 [0–1] | 1 [0–6] | < 0.001 |
CT-scan: | ||||
Visualization of vessel obstruction (%) | 28 | 36 | 24 | 0.1 |
Hypo-enhancement of bowel wall (%) | 64 | 45 | 73 | < 0.001 |
Bowel wall thickening (%) | 37 | 45 | 33 | 0.11 |
Dilated bowel segment (%) | 37 | 37 | 35 | 0.9 |
Fat stranding (%) | 24 | 28 | 22 | 0.71 |
Pneumatosis intestinalis (%) | 37 | 27 | 43 | 0.04 |
Air in mesenteric vessels (%) | 20 | 15 | 22 | 0.25 |
Arteriography performed (%) | 8 | 17 | 5 | 0.002 |
Laparotomy: | ||||
Not performed (%) | 31 | 22 | 35 | – |
Performed < 24 h post-diagnosis (%) | 66 | 75 | 62 | – |
Performed > 24 h post-diagnosis (%) | 3 | 3 | 3 | – |
Autopsy: | ||||
Autopsy performed (%) | 17 | 0 | 25 | – |
Discovery of AMI during autopsy (%) | 5 | 0 | 5 | – |
Therapeutic procedures | ||||
Vasopressors in the 24 h preceding diagnosis (%) | 51 | 19 | 68 | < 0.001 |
Maximal dose of vasopressors (gamma/min) (median [IQR]) | 30 [10–53] | 7 [0–23] | 38 [20–67] | < 0.001 |
Vasopressors post-diagnosis (%) | 81 | 55 | 93 | < 0.001 |
Antimicrobial therapy (%) | 89 | 90 | 91 | 0.61 |
Anticoagulation (%) | 62 | 81 | 53 | < 0.001 |
Scores | ||||
SOFA (mean ± SD) | 8.7 ± 5 | 6 ± 4 | 10 ± 4.7 | < 0.001 |
APACHE II (mean ± SD) | 25 ± 10 | 19 ± 7.4 | 27 ± 10 | < 0.001 |
Comorbidities during ICU stay | ||||
New onset of atrial fibrillation (%) | 14 | 12 | 15 | 0.48 |
Acute pancreatitis (%) | 8 | 1 | 11 | 0.014 |
Sepsis, septic shock (%) | 58 | 43 | 65 | 0.002 |
SCVO2 < 70% or need for inotropic agent (%) | 71 | 47 | 83 | < 0.001 |
Mechanical ventilation 24 h before diagnosis (%) | 47 | 18 | 61 | < 0.001 |
RRT after diagnosis (%) | 52 | 31 | 60 | < 0.001 |