Published online Aug 27, 2022. doi: 10.4240/wjgs.v14.i8.809
Peer-review started: April 19, 2022
First decision: June 10, 2022
Revised: July 2, 2022
Accepted: July 20, 2022
Article in press: July 20, 2022
Published online: August 27, 2022
Processing time: 127 Days and 2.6 Hours
Mesenteric ischemia is significantly more common in end-stage kidney disease patients undergoing chronic dialysis than in the general population and is associated with high morbidity and mortality. However, reports on prognostic factors in this population are limited.
Reports on prognostic factors in chronic dialysis patients with acute mesenteric ischemia are lacking.
The aim of this retrospective study was to identify the protective factors for mesenteric ischemia in chronic dialysis patients to promote earlier initiation of aggressive therapy in this targeted population and improve their poor prognosis.
One hundred and three chronic dialysis patients with surgically confirmed acute mesenteric ischemia in a tertiary medical center over 14 years were retrospectively analyzed. Cox regression and Kaplan-Meier analysis were used for prognostic analysis by R statistical analysis software.
The in-hospital mortality rate among the 103 enrolled patients was 46.6%. Univariate analysis was performed to compare factors in survivors and nonsurvivors, with better in-hospital outcomes associated with a surgery delay (defined as the time from onset of signs and symptoms to operation) < 4.5 d, no shock, no resection of the colon, and a total bowel resection length < 110 cm. Following multivariate adjustment, resection not involving the colon (HR 2.70, 95%CI 1.05 to 7.14; P = 0.039), and a total bowel resection length < 110 cm (HR 4.55, 95%CI 1.43 to 14.29; P = 0.010) were significantly associated with survival.
A surgery delay < 4.5 d, no shock, no resection of the colon, and a total bowel resection length < 110 cm predicted better outcomes in chronic dialysis patients with acute mesenteric ischemia.
This study emphasizes that early diagnosis and prompt surgical intervention in chronic dialysis patients with acute mesenteric ischemia are beneficial.