Abstract

Background: The morbidity and mortality in patients suffering from acute ischemic bowel disease can be markedly increased if the condition is not recognized and managed in a timely manner. There is a potential correlation between old age-related atherosclerotic cardiovascular disease (ASCVD)/atrial fibrillation and acute ischemic bowel disease. The present study aimed to further determine whether old age-related ASCVD/atrial fibrillation affects mortality of acute ischemic bowel disease.

Methods: The records of 709 patients with acute ischemic bowel disease were retrospectively reviewed. All data were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV version 2.2) database 2008 to 2019.

Results: Patients with older age (≥ 65 years) had longer hospital stays, higher in-hospital mortality, and higher total mortality compared to those under 65.  In the older age group, atrial fibrillation (hazard ratio [HR] = 2.307, 95% confidence interval [CI]: 1.290–4.128) and high baseline aspartate aminotransferase (AST) (HR = 1.001, 95% CI: 1.001–1.002) were independent predictors of higher in-hospital mortality. ASCVD (HR = 1.397, 95% CI: 1.024–1.904), male sex (HR = 1.469, 95% CI: 1.051–2.053), high baseline white blood cell (WBC) count (HR = 1.026, 95% CI: 1.002–1.051) and high baseline AST (HR = 1.001, 95% CI: 1.001–1.002) were independent predictors of higher total mortality, while high baseline hemoglobin (HR = 0.864, 95% CI: 0.758–0.985)was as an  independent predictor of lower total mortality.

Conclusion: Old age-related ASCVD and atrial fibrillation are adverse prognostic factors for total and in-hospital mortality in patients with acute ischemic bowel disease, respectively.