A PROSPECTIVE STUDY OF PATIENTS WITH SUSPECTED ACUTE MESENTERIC ISCHEMIA meis.jawad1@gmail.com

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A PROSPECTIVE STUDY OF PATIENTS WITH SUSPECTED ACUTE MESENTERIC ISCHEMIA

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Sweden

Oral only

The BIPAMI (Biomarkers in Prediction of Acute Mesenteric Ischaemia) is an ongoing multicentre international prospective study. This substudy on patients from one vascular centre aimed to evaluate admission clinical and laboratory parameters distinguishing confirmed acute mesenteric ischemia (AMI) from non-AMI.

Prospective data were collected at Skåne University Hospital (October 2024-July 2025). Patients with suspected AMI at admission were included. Diagnosis was confirmed by computed tomography (CT), angiography, endoscopy, or intraoperatively.

Forty patients were included (23 with confirmed AMI; 17 with non-AMI). The 23 patients with AMI had superior mesenteric artery (SMA) thrombosis (n=8), SMA embolism (n=4), superior mesenteric vein thrombosis (n=3), acute SMA dissection (n=1), and non-occlusive mesenteric ischaemia (n=5). Endovascular intestinal revascularization and bowel resection were performed in 10 (43.5%) and 6 (26.1%) AMI patients, respectively. History of smoking (68.0% vs. 32.0%, p=0.083) and vomiting at admission (43.5% vs. 17.6%, p=0.085) were more frequent in the AMI group, whereas anaemia (39.1% vs. 58.8%, p=0.073) and bloody stools (8.7% vs. 29.4%, p<0.088) were more common in the non-AMI group; all non-significant. AMI patients had higher admission leukocyte count (15.6 ×10⁹/L versus 8.8, p = 0.004) and plasma lactate (3.35 mmol/L versus 1.90 mmol/L p=0.021). In-hospital mortality was 30.4% and 11.8%, respectively (p=0.256). In multivariable analysis, bloody stools (odds ratio [OR] 0.016, 95% confidence interval [CI] 0.0-0.76; p=0.036) and plasma lactate (OR 7.1 per standard deviation increment, 95% CI 1.16-43.9; p=0.034) remained independently associated with AMI.

Confirmed AMI was associated with elevated plasma lactate and absence of macroscopic bloody stools.