Risk Factors for 30-day Mortality After Emergency Surgery for Non-occlusive Mesenteric Ischemia.

Background/aim: Non-occlusive mesenteric ischemia (NOMI) is a rare and highly fatal disease characterized by intestinal ischemia or necrosis despite the absence of obstruction of the mesenteric vessels. This research aimed to investigate the risk factors for 30-day mortality of NOMI after emergency surgery.

Patients and methods: We analyzed 42 consecutive patients who underwent emergency surgery for NOMI from April 2015 to August 2022. Patients were divided into two groups, based on 30-day postoperative survival as follows: early death (30-day mortality group, n=9) and survival (survivor group, n=33). The characteristics, past history, and surgical outcomes were compared between the groups.

Results: The 30-day mortality rate was 21.4%. There were no significant differences in the patients' characteristics and surgical complications between groups. However, the 30-day mortality group had a significantly higher number of patients with chronic kidney disease (CKD) (p<0.01) and on hemodialysis (p=0.01), as well as a significantly lower platelet count (p=0.02). In the multivariate analysis, a preoperative lactate dehydrogenase >1,127 U/l was identified as an independent risk factor for 30-day mortality following emergency surgery for NOMI (odds ratio=23.6; 95% confidence interval=2.12-262.9; p=0.01).

Conclusion: CKD, hemodialysis, high LDH, and low platelet count were found to be risk factors for early mortality from NOMI.