AI Summary & Key Takeaways
AI InsightAlthough the study was underpowered to detect small effect sizes, the observed correlations with metabolic derangement markers support further prospective investigation.
📌 3 Key Takeaways
Abstract
Aims: To evaluate whether preoperative CT-derived spleen density is associated with in-hospital mortality and bowel resection requirement in patients managed for acute mesenteric ischemia (AMI), and to explore its potential role as an imaging-based prognostic biomarker. Methods: This hypothesis-generating retrospective cohort study included 71 consecutive AMI patients at Ankara Etlik City Hospital (January 2022- July 2025). Spleen density was measured by two independent observers on preoperative contrast enhanced CT (portal venous phase; 5 mm slices) at three standardised levels and expressed as mean Hounsfield units (HU). Groups were compared by Mann-Whitney U or Chi-square/Fisher's exact test. Multivariable binary logistic regression identified independent predictors of in-hospital mortality. ROC curves were generated with Youden-optimal cut-offs. A pre-specified sensitivity analysis was restricted to operated patients (n=62). Results: In-hospital mortality was 52.1% (37/71). Median spleen density was 88.2 HU (IQR 53.0). Spleen density did not differ between survivors and non-survivors (90.2 vs. 80.5 HU; p=0.332) or in the operated-only sensitivity analysis (94.8 vs. 73.6 HU; p=0.275), nor between resection groups (p=0.074). Age (OR 1.078, 95% CI 1.024-1.135; p=0.004) and lactate (OR 1.453, 95% CI 1.012-2.088; p=0.043) were independent mortality predictors; spleen density was not (OR 0.999; p=0.877). Spleen density showed moderate inverse correlations with lactate, creatinine, and LDH. Conclusion: Preoperative spleen density was not independently associated with mortality or bowel resection in this exploratory AMI cohort. Although the study was underpowered to detect small effect sizes, the observed correlations with metabolic derangement markers support further prospective investigation.