Preoperative risk factors for negative clinical outcomes in acute mesenteric thrombosis in surgical ICU

Background. Acute mesenteric thrombosis (AMT) is a condition that develops with thrombosis in the vessels of the mesenteric pool, which causes hypoperfusion of the intestinal wall and leads to secondary inflammatory changes. Mortality in OMT is 80–85 %. Early diagnosis of OMT is difficult due to the lack of specific clinical signs and laboratory markers.

Objective. To identify preoperative risk factors for adverse clinical outcomes in OMT.

Design and Methods. A single-center retrospective observational cohort study included 47 patients diagnosed with OMT. The following patient data were analyzed: age, gender, body mass index (BMI), assessment of the patients’ condition according to the SOFA, APACHE II, EuroSCORE scales. Various laboratory parameters in the preoperative and postoperative periods were analyzed.

Results. The incidence of oncological diseases and history of acute cerebrovascular accident (ACV) were significantly higher in the group of lethal outcomes of OMT than in the group of surviving patients. The correlation of higher serum levels of lactate, D-dimer, creatinine, leukocytosis and procalcitonin in the preoperative period with the development of an unfavorable clinical outcome was revealed.

Conclusion. The main risk factors for the development of an unfavorable clinical outcome of mesenteric thrombosis in patients are the presence of malignant neoplasms, a history of stroke, a high level of mixed venous blood lactate, creatinine, D-dimers, procalcitonin, leukocytosis in the preoperative period.

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