Preoperative Risk Factors for Short-Term Postoperative Mortality of Acute Mesenteric Ischemia after Laparotomy: A Systematic Review and Meta-Analysis
Table 2
Association between clinical characteristics and short-term postoperative mortality.
Factor
Number of studies
Number of patients
OR (95% CI) (nonsurvivors: survivors) or standardized mean difference (nonsurvivors-survivors) of factor
value
Heterogeneity (I2), %
Demographic
Age
8
2900
0.32 (0.24–0.40)
<0.0001
0.00
Old age
4
2502
1.90 (1.57–2.30)
<0.0001
0.00
Male sex
11
3126
1.03 (0.87–1.21)
0.75
4.46
Comorbidities
Coronary heart disease
6
2782
1.14 (0.70–1.88)
0.59
59.24
Atrial fibrillation
4
581
1.42 (0.79–2.55)
0.24
52.01
Heart failure
4
2534
1.33 (1.03–1.72)
0.03
0.00
Hypertension
6
2866
1.19 (0.57–2.48)
0.64
87.56
Atherosclerosis
2
393
0.84 (0.54–1.30)
0.43
0.00
Arrhythmia
2
2379
1.62 (1.33–1.98)
<0.0001
0.00
Previous cardiac disease
3
326
1.80 (0.86–3.73)
0.12
55.84
Diabetes
9
3307
1.51 (0.97–2.36)
0.07
65.92
Chronic lung disease
3
2453
1.34 (1.04–1.73)
0.02
0.00
Renal disorders
5
2683
1.61 (1.24–2.07)
0.0003
14.33
Peripheral vascular diseases
5
2641
1.38 (1.00–1.91)
0.05
0.00
Comorbidity
2
199
3.49 (1.88–6.46)
<0.0001
0.00
Etiology
AOMI vs MVT
4
379
2.45 (1.12–5.33)
0.04
11.10
NOMI versus AOMI
5
486
1.33 (0.56–3.16)
0.52
56.86
NOMI versus MVT
4
379
2.50 (0.79–7.93)
0.12
27.23
Medications history
Antiplatelet
5
764
2.23 (0.77–6.44)
0.14
81.15
Anticoagulant therapy
3
525
0.59 (0.19–1.79)
0.35
65.48
Digoxin
2
239
3.77 (2.02–7.02)
<0.0001
0.00
Initial clinical symptoms
Abdominal pain
4
462
0.71 (0.18–2.81)
0.63
74.02
Abdominal distension
2
231
1.43 (0.76–2.68)
0.27
0.00
Diarrhea
2
231
0.62 (0.31–1.27)
0.19
0.00
Vomiting
2
231
0.59 (0.35–0.99)
0.05
0.00
Physical findings
Fever
2
239
0.96 (0.44–2.07)
0.91
0.00
Body temperature
2
231
0 (−0.26–0.25)
0.99
0.00
Pulse rate
2
231
0.42 (0.16–0.68)
0.002
6.58
Blood pressure
2
231
−1.00 (−2.18–0.18)
0.1
94.38
Hypotension after admission
2
227
2.86 (1.39–5.91)
0.005
0.00
peritonitis
2
210
1.72 (0.93–3.17)
0.08
0.00
Sepsis
2
227
2.10 (1.16–3.80)
0.01
0.00
Shock
2
239
4.18 (1.99–8.78)
0.0002
0.00
Computed tomography findings
Bowel-wall thickening
2
426
0.49 (0.24–0.99)
0.05
33.45
Intramural pneumatosis
2
426
3.87 (0.23–63.98)
0.35
84.90
Laboratory tests
White blood cell
7
917
0.04 (−0.46–0.53)
0.89
91.47
Platelet
4
566
−0.32 (−0.50 to −0.14)
0.0004
0.00
Hemoglobin
3
541
−0.16 (−0.46–0.14)
0.29
60.29
Amylase
3
342
1.24 (−0.22–2.70)
0.1
96.98
AST
2
405
0.60 (0.10–1.10)
0.02
74.99
CPK
3
541
0.59 (0.00–1.17)
0.05
89.02
Lactate
2
405
0.85 (0.58–1.12)
<0.0001
25.49
PH
3
541
−1.11 (−1.67 to −0.55)
<0.0001
86.89
BUN
2
231
0.93 (0.11–1.75)
0.03
88.69
Creatinine
5
768
0.50 (0.25–0.75)
<0.0001
60.38
Bicarbonate
2
239
−2.34 (−5.78 to 1.09)
0.18
98.77
Bilirubin
2
405
0.12 (−0.09 to 0.33)
0.26
0.00
CRP
2
339
0.29 (0.05–0.52)
0.02
0.00
CRP ≥ 100 mg/L
2
350
0.46 (0.29–0.75)
0.002
0.00
Continuous variables compared by standardized mean difference. A negative value indicates mean value was lower in nonsurvivors than survivors. AST: aspartate aminotransferase; AOMI: arterial occlusive mesenteric ischemia; BUN: blood urea nitrogen; CPK: creatine phosphokinase; CRP: C-reactive protein; MVT: mesenteric venous thrombosis; NOMI: nonocclusive mesenteric ischemia.
