Predictive value of certain biomarkers and immune indices in estimating mortality and morbidity in acute mesenteric ischemia

Aim:The purpose of this study is to investigate the predictive value of certain biomarkers, which are measurable and easily accessible in the early stages of the disease, and immune indices derived from complete blood count parameters, for predicting mortality and major morbidities in patients diagnosed with acute mesenteric ischemia. Material and Method: Patients diagnosed with acute mesenteric ischemia and operated on in the general surgery clinic of our hospital were included in the study. The patients were divided into two groups: the survivor group (SG) and the non-survivor group (NSG). Three different immune indices (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index), which are derived from the patients' biochemical blood parameters and complete blood count parameters and are indicators of the systemic inflammatory response, were calculated. Their effect on predicting mortality was analyzed. Results: While 54 (66.6%) of these patients died, 27 (33.3%) patients were discharged with recovery. There were statistically significant differences between the two groups in terms of sodium, creatinine, lactate, and lactate dehydrogenase (LDH) values (p<0.05 for each). In the regression analyses performed, lactate (p<0.001) and LDH (p=0.004) were observed to be independent predictors. When looking at other biochemical parameters between the groups; hemoglobin, leukocyte (White blood count -WBC-), C-reactive protein (CRP), platelet, glucose, and albumin values did not show a significant difference (p>0.05 for each). There was also no significant difference between the groups in terms of leukocyte subgroups (neutrophil, lymphocyte, monocyte, eosinophil) (p>0.05 for each). When evaluated in terms of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), no significant difference was observed between the groups (p>0.05 for each). Although there was no statistically significant difference between the two groups in terms of the number of debridements performed (p=0.86), the length of hospital stay was significantly higher in the SG (p=0.001). Conclusion: In our study, it was demonstrated that particularly preoperative lactate levels are a strong marker of mortality, while LDH has a more limited but significant prognostic value. Although serum sodium and creatinine levels were associated with survival, they did not carry independent predictive value.