Identifying survival protective factors for chronic dialysis patients with surgically confirmed acute mesenteric ischemia

Table 1 Demographic data of chronic dialysis patients with acute mesenteric ischemia

Variable	Total (n = 103)	Survival (n = 55)	Death (n = 48)	P value
Age (yr) (mean ± SD)	68.3 ± 11.3	68.5 ± 10.6	68.0 ± 12.3	0.811
BMI	23.8 ± 3.7	23.5 ± 2.9	24.3 ± 4.6	0.323
Sex, n (%)				0.495
Male	39 (37.9)	23 (59.0)	16 (41.0)
Female	64 (62.1)	32 (50.0)	32 (50.0)
Comorbidities, n (%)
Diabetes mellitus	56 (54.4)	32 (57.1)	24 (42.9)	0.527
Hypertension	65 (63.1)	35 (53.8)	30 (46.2)	1.000
Coronary artery disease	18 (17.5)	10 (55.6)	8 (44.4)	1.000
Heart failure	11 (10.7)	6 (54.5)	5 (45.5)	1.000
Atrial fibrillation	5 (4.9)	2 (40.0)	3 (60.0)	0.662
Prior stroke	15 (14.6)	10 (66.7)	5 (33.3)	0.404
Peripheral arterial occlusive disease	10 (9.7)	4 (40.0)	6 (60.0)	0.508
Cirrhosis	3 (2.9)	1 (33.3)	2 (66.7)	0.597
Peptic ulcer disease	24 (23.3)	11 (45.8)	13 (54.2)	0.539
Chronic obstructive pulmonary disease	3 (2.9)	1 (33.3)	2 (66.7)	0.597
Malignancy	13 (12.6)	8 (61.5)	5 (38.5)	0.740
Immunosuppressive status	2 (1.9)	1 (50.0)	1 (50.0)	1.000
RRT modality
Hemodialysis	100 (97.1)	55 (55.0)	45 (45.0)	0.098
Peritoneal dialysis	8 (7.8)	1 (12.5)	7 (87.5)	0.024a

^aP < 0.05.

BMI: Body mass index; RRT: Renal replacement therapy.

Table 2 Clinical characteristics of chronic dialysis patients with acute mesenteric ischemia

Characteristics	Total (n = 103)	Survival (n = 55)	Death (n = 48)	P value
Surgery delay (d) (mean ± SD)	2.6 ± 3.1	2.3 ± 2.8	2.9 ± 3.5	0.296
Complications, n (%)
Shock	87 (84.5)	41 (47.1)	46 (52.9)	0.007a
Laboratory data
Hospital day 1
WBC (k/μL)	12.86 ± 6.21	11.69 ± 5.49	14.21 ± 6.74	0.041a
Hemoglobin (g/dL)	11.06 ± 2.40	11.22 ± 2.30	10.88 ± 2.53	0.476
Platelet (k/μL)	195.47 ± 76.10	189.76 ± 65.39	202.00 ± 87.03	0.418
PMN (%)	82.36 ± 10.74	80.87 ± 11.59	84.08 ± 9.50	0.126
Lymphocytes (%)	9.28 ± 6.10	10.12 ± 6.34	8.32 ± 5.72	0.132
CRP (mg/L)	180.12 ± 138.86	167.23 ± 136.09	193.60 ± 142.03	0.377
Potassium (mEq/L)	4.47 ± 1.02	4.71 ± 1.08	4.19 ± 0.89	0.008a
Albumin (g/dL)	2.82 ± 0.59	2.91 ± 0.41	2.70 ± 0.74	0.080
Total bilirubin (mg/dL)	0.86 ± 0.61	0.78 ± 0.34	0.94 ± 0.79	0.230
Hospital day 7
WBC count (k/μL)	11.87 ± 6.94	10.05 ± 5.04	13.96 ± 8.19	0.004a
Hemoglobin (g/dL)	9.56 ± 1.74	9.39 ± 1.76	9.75 ± 1.72	0.297
Platelets (k/μL)	159.35 ± 94.81	173.94 ± 72.26	142.94 ± 113.62	0.099
PMN (%)	79.71 ± 11.77	78.69 ± 8.83	80.90 ± 14.49	0.347
Lymphocytes (%)	10.16 ± 8.08	10.19 ± 5.60	10.13 ± 10.33	0.975
CRP (mg/L)	157.71 ± 89.16	119.34 ± 81.27	191.94 ± 82.54	0.000a
Potassium (mEq/L)	4.08 ± 0.85	3.94 ± 0.68	4.24 ± 1.00	0.075
Albumin (g/dL)	2.50 ± 0.43	2.50 ± 0.47	2.50 ± 0.41	0.977
Total bilirubin (mg/dL)	1.62 ± 1.93	1.11 ± 1.75	2.05 ± 2.00	0.053
Echocardiographyin hospital
LVEF	0.65 ± 0.13	0.66 ± 0.11	0.62 ± 0.16	0.199
Etiology of mesenteric ischemia, n (%)
Arterial embolism	0 (0)	0 (0.0)	0 (0.0)	NA
Arterial thrombosis	5 (4.9)	2 (40.0)	3 (60.0)	0.664
Venous thrombosis	0 (0)	0 (0.0)	0 (0.0)	NA
Nonocclusive	97 (95.1)	52 (53.6)	45 (46.4)	0.664
Bowel resection site, n (%)
Jejunum	28 (27.5)	12 (42.9)	16 (57.1)	0.302
Ileum	82 (80.4)	48 (58.5)	34 (41.5)	0.041a
Colon	42 (41.2)	18 (42.9)	24 (57.1)	0.132
Rectum	2 (2.0)	0 (0.0)	2 (100.0)	0.219
Bowel resection length (cm) (mean ± SD)
Small intestine	65.39 ± 58.86	59.84 ± 48.80	71.64 ± 68.43	0.314
Colon	14.23 ± 23.93	11.88 ± 24.30	16.88 ± 23.47	0.294
Total	78.85 ± 58.36	70.41 ± 48.18	88.52 ± 67.43	0.117

^aP < 0.05.

WBC: White blood cell; PMN: Polymorphonuclear leukocytes; CRP: C-reactive protein; LVEF: Left ventricular ejection fraction.

Table 3 Univariate and multivariate Cox regression analysis of protective factors for in-hospital survival

Variable	Protective measurement univariate	Protective measurement multivariate
	Hazard ratio (95%CI)	Hazard ratio (95%CI)
Surgery delay < 4.5 d	2.63 (1.11-6.25)a	2.70 (0.69-10.0)
No shock	2.86 (1.49-5.26)a	1.67 (0.33-8.33)
Potassium level in hospital on day 1	1.44 (1.13-1.83)a	1.78(1.25-2.54)a
WBC count in hospital on day 7	0.93 (0.88-0.98)a	0.94 (0.85-1.03)
Neutrophil count in hospital on day 7	0.96 (0.93-0.99)a	0.92 (0.84-1.00)a
Lymphocyte count in hospital on day 7	1.06 (1.01-1.11)a	0.89 (0.76-1.04)
CRP level in hospital on day 7	0.99 (0.99-1.00)a	0.99 (0.99-1.00)
No resection of colon	2.08 (1.15-3.85)a	2.70 (1.05-7.14)a
Total resection length < 110 cm	2.33 (1.18-4.76)a	3.85 (1.41-11.11)a

^aP < 0.05

WBC: White blood cell; CRP: C-reactive protein.