Could risk factors be better predictors of early acute mesenteric ischemia than laboratory and imaging studies? Retrospective study and algorithm for the early intervention
Objectives The aim is to delineate relevant risk factors and construct an algorithm for earlier performance of selective mesenteric angiography, thus lowering mortality rates of acute mesenteric ischemia. Methods During a 5-year period 31 patients were examined. Thirteen risk factors were analysed and compared to standard diagnostic procedures. Results Only one patient did not have arterial hypertension. The second most common risk factor is atrial fibrillation with the incidence rate of 64.5%. The largest group of patients (38.7%) had two risk factors and there were 6.5% patients with six risk factors and 87.2% of all patients had two or more risk factors. In 67.7% of the patients we only performed emergency laparotomy due to inoperable state. Hospital mortality was 74.2%. Conclusions Combination of age over 70, hypertension and two or more risk factors associated with elevated D-dimers, in a patient with severe abdominal pain and minimal clinical findings with nonspecific laboratory findings and plain abdominal radiographs, could be an indication for early selective mesenteric angiography.
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