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KMID : 1033220140040020079
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Journal of Acute Care Surgery
2014 Volume.4 No. 2 p.79 ~ p.84
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Abnormal Liver Functions as a Risk Factor for Acute Mesenteric Ischemia
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Choi Eol
Hong Suk-Kyung
Hwang Ji-Hee
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Abstract
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Purpose: Acute mesenteric ischemia (AMI) is a potentially fatal condition resulting from inadequate blood supply to the bowels. The clinical features and prognostic factors of AMI are described to aid physicians in clinical decision making.
Methods: The electronic medical records of 39 patients (19 women, mean age: 65.26±11.13 years) who underwent surgery for AMI from 2007 to 2009 were retrospectively collected and analyzed. Clinical variables and laboratory parameters on the day of admission or first day of symptoms were analyzed. The primary outcome of interest was patient survival. Multivariate analysis was performed to identify independent predictive factors associated with poor outcome.
Results: Co-morbidities included hypertension (27/39 patients) and diabetes mellitus (14/39). Most patients (23/39) visited the emergency room for AMI-related symptoms, others (16/39) had their first symptom during an unrelated hospitalization. The mean blood pressure at initial assessment was 93.5±23.9 mmHg and pulse rate was 101 beats/min. Fever was experienced by 17/39 and shock by 13/39 patients. Patients underwent bowel resection (32/39) or diagnostic laparotomy (7/39). The mean intensive care unit stay was 13 postoperative days and hospital stay, 28.3 days. Twenty-two patients (56.1%) were discharged with improvement, and 17 patients (43.9%) died. Acute renal failure, elevated aspartate aminotransferase (AST), elevated alanine aminotransferase (ALT), abnormal bilirubin, and shock were significantly associated with death by univariate analysis. Elevated AST and ALT were strongly associated with mortality by multivariate analysis with logistic regression.
Conclusion: Abnormal liver function indices may be predictive of poor prognosis among patients with AMI. (J Acute
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KEYWORD
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Mesenteric vascular diseases, Liver diseases, Aspartate aminotransferases, Bilirubin, Intensive care units
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