Are Mortality and Morbidity Predictable in Acute Mesenteric Ischemia? The Importance of Serum Lactate, Lactate Dehydrogenase, and Blood Urea Nitrogen Levels

Acute mesenteric ischemia (AMI) is a rare cause of acute abdomen in which blood flow in the intestines is disrupted for any reason. In this study, we aimed to determine the predicting effects of demographic and clinical data, particularly laboratory parameters including lactate (Lac), lactate dehydrogenase (LDH), and blood urea nitrogen (BUN) in the preoperative period in AMI. The patients who were hospitalized and treated with the diagnosis of AMI were included in the study. Demographic, clinical, laboratory, and surgery-related parameters of the patients were analyzed retrospectively. The mean age of the patients included in the study was 69.1 ± 9.3 (54–89 years). The mortality rate among patients was 45.8%. The preoperative serum LDH (p < 0.001) and Lac (p < 0.001) levels were significantly higher in the patient group with mortality than in the patient group without mortality. Preoperative Lac (AUC = 0.947) and LDH (AUC = 0.962) levels were found to be a strong predictor of mortality. However, the preoperative BUN levels alone were not a sufficient predictor of mortality (AUC = 0.643, p = 0.094). A preoperative Lac level above 3.76 mmol/l was a predictor of mortality with 100% sensitivity and 80.8% specificity. A preoperative LDH level above 391 IU/l was a predictor of mortality with 90.9% sensitivity and 88.5% specificity. A preoperative BUN level above 66 mg/dl was a predictor of mortality with 40.9% sensitivity and 100% specificity. Early evaluation of serum Lac, LDH, and BUN levels as well as simultaneous monitoring with treatment may be a significant predictive parameter in the survival and reduction of complications in AMI.