Analysis on clinical characteristics of acute occlusive mesenteric ischemia and development of a risk prediction model for intestinal necrosis
HAN Yu-min
JIANG Xiao-mei
ZHANG Gui-xiang
HUANG Li-bin
FENG Li
HUANG Bin
ZHANG Shu
LIU Cong
YANG Lie
Abstract：Objective To analyze the factors influencing clinical outcomes in patients with acute occlusive mesenteric ischemia(AOMI)and to develop and validate a clinical prediction model for intestinal necrosis.Methods A retrospective analysis was conducted on clinical data from 236 AOMI patients admitted to West China Hospital of Sichuan University between January 2020 and December 2023,including 108 cases of acute arterial mesenteric ischemia(AAMI)and 128 cases of mesenteric venous thrombosis(MVT).The clinical characteristics of AOMI cases were analyzed,and logistic regression was used to identify risk factors for poor outcomes.Further,patients with confirmed intestinal necrosis status were selected to compare clinical features,construct a prediction model,and perform internal validation.Results Multivariate analysis revealed that organic heart disease(OR=5.030,95％CI 1.675-15.123),portal hypertension(OR=16.557,95％CI 1.094-249.326),WBC count ≥10×109/L(OR=9.670,95％CI 2.193-42.668),platelet count＜100×109/L(OR=9.122,95％CI 2.235-37.262),total bilirubin ≥17.1 μmol/L(OR=3.175,95％CI 1.148-8.786),and AAMI(OR=38.862,95％CI 2.005-752.530)were independent risk factors for poor outcomes(all P＜0.05).The intestinal necrosis prediction model integrated imaging features and laboratory indicators,including intestinal cavity effusion(OR=3.466,95％CI 1.468-8.175),mesenteric swelling(OR=2.373,95％CI 1.008-5.582),intestinal wall swelling(OR=1.742,95％CI 0.738-4.093),white blood cell count(OR=2.509,95％CI 0.950-6.587),D-dimer(OR=2.165,95％CI 0.952-4.976),albumin(OR=0.449,95％CI 0.163-1.248),and lymphocyte percentage(OR=0.883,95％CI 0.335-2.308).The training set demonstrated an AUC of 0.808(95％CI 0.742-0.891,sensitivity 0.742,specificity 0.781),while the validation set showed an AUC of 0.793(95％CI 0.664-0.913,sensitivity 0.668,specificity 0.734),with calibration curves indicating good consistency between groups.Conclusion The prediction model for intestinal necrosis,constructed based on multidimensional clinical data including imaging features and laboratory indicators,exhibits high accuracy and clinical utility.It provides a quantitative foundation for early intervention,personalized treatment,and optimization of emergency protocols in AOMI patients.
Keywords：acute occlusive mesenteric ischemiaintestinal necrosisclinical featuresinfluencing factorsprediction model
Publication Date：2025-04-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 443-449 )