Export Objective: Acute mesenteric ischemia (AMI) is a critical vascular emergency with a high mortality rate often due to delayed diagnosis and intervention. This study aimed to evaluate the clinical outcomes and identify predictors of mortality among patients with AMI at a tertiary hospital in Sana’a, Yemen. Methods: We conducted a prospective observational study involving 31 patients diagnosed with AMI between August 2022 and February 2024 at the Al-Thawra Modern General Hospital, Sana’a, Yemen. Data on demographics, clinical presentation, diagnostic methods, management strategies, and outcomes were collected. Statistical analysis was performed to identify factors associated with increased mortality. Results: The mean age of the patients was 55.29 years (standard deviation±14.77), with 20 (64.5%) males and 11 (35.5%) females. All patients presented with severe abdominal pain (100%), vomiting 29 (93.5%), and nausea 31 (100%). Arterial AMI was identified in 28 (90.3%) patients and all 31 (100%) patients underwent surgical intervention with bowel resection in 25 (80.6%) patients. The overall mortality rate was 51.6% (n=16). Significant predictors of mortality included delayed presentation beyond 48 hours in 19 patients (61.3%, P < 0.014), heart failure in 7 (70%, P=0.004), ischemic stroke in 4 (100%, P=0.001), hemodynamic instability in 12 (66.7%, P=0.020), leukocytosis in 10 (76.9%, P=0.025), elevated aspartate aminotransferase/alanine aminotransferase in 14 (82.4%, P < 0.001), and elevated lactate dehydrogenase in 15 (68.2%, P=0.004). Conclusions: AMI has a high mortality rate, particularly in resource-limited settings, such as Yemen. Early diagnosis and prompt surgical intervention are critical to improve patient survival. Managing comorbidities, such as heart failure, and early identification of high-risk patients are essential to reduce mortality. Further studies are needed to enhance early detection and optimize treatment outcomes.
Al-Amry et al. (Tue,) studied this question.