Journals / Eskisehir Medical Journal / 2026 / Volume: 7 Issue: 3

Treatment Strategy and Intervention Timing in Elderly Patients with Acute Mesenteric Ischemia: A Multicenter Retrospective Cohort Study

Mehmet Emin Gönüllü(BILECIK SEYH EDEBALI UNIVERSITY, SCHOOL OF MEDICINE)0000-0001-9126-2396
Ahmet Tuğrul Zeytin(BILECIK SEYH EDEBALI UNIVERSITY)0000-0002-1420-5475
Gürkan Güneri(BILECIK SEYH EDEBALI UNIVERSITY)0000-0001-6749-2159
Kadir Çorbacı(BILECIK SEYH EDEBALI UNIVERSITY)0000-0001-7616-4798
Mücahit Ünal(BILECIK SEYH EDEBALI UNIVERSITY)0000-0001-9941-5166
Pages
—
Publication Date
2026-08-29
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

However, these findings should be interpreted cautiously because of the retrospective study design and the possibility of residual confounding.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Introduction: This study aimed to evaluate the association between treatment modality, intervention timing, and clinical outcomes in patients aged 65 years or older with acute mesenteric ischemia (AMI).
📊
Key Findings & Data:Methods: This multicenter retrospective cohort study included 126 patients aged 65 years or older who were diagnosed with AMI between January 2015 and December 2025.
💡
Conclusion & Impact:However, these findings should be interpreted cautiously because of the retrospective study design and the possibility of residual confounding.
🔬Design:Research Article
📍Scope:2015 Verileri
⚙️Variables:Acute mesenteric ischemia · Endovascular treatment · Open surgery

Abstract

Introduction: This study aimed to evaluate the association between treatment modality, intervention timing, and clinical outcomes in patients aged 65 years or older with acute mesenteric ischemia (AMI). Methods: This multicenter retrospective cohort study included 126 patients aged 65 years or older who were diagnosed with AMI between January 2015 and December 2025. Patients were classified according to treatment modality as endovascular treatment, open surgery, or conservative management. The primary outcome was 30-day mortality. Secondary outcomes included in-hospital mortality, intensive care unit admission, length of hospital stay, complications, and reoperation. Propensity score–based inverse probability of treatment weighting (IPTW) and multivariable logistic regression analyses were performed to reduce potential confounding. Results: The 30-day mortality rate was lower in the endovascular treatment group (26.2%) than in the open surgery (45.5%) and conservative management (45.0%) groups (p=0.041). Delayed intervention (>12 hours) was associated with an increased risk of mortality (OR: 2.68; 95% CI: 1.18–6.09; p=0.018). Serum lactate level, age, and Charlson Comorbidity Index were identified as independent predictors of 30-day mortality. In the IPTW-adjusted analysis, open surgery was associated with higher mortality compared with endovascular treatment (OR: 1.94; 95% CI: 1.05–3.58; p=0.034). Conclusion: Treatment modality and timing of intervention appear to be associated with clinical outcomes in elderly patients with AMI. Endovascular treatment was associated with lower 30-day mortality, whereas delayed intervention was linked to poorer outcomes. However, these findings should be interpreted cautiously because of the retrospective study design and the possibility of residual confounding.

🔖

Cite This Article

Gönüllü, M. E., Zeytin, A. T., Güneri, G., Çorbacı, K., Ünal, M., Gürsoy, F., Yekenkurul, E., Çetin, M. F. (2026). Treatment Strategy and Intervention Timing in Elderly Patients with Acute Mesenteric Ischemia: A Multicenter Retrospective Cohort Study. Eskisehir Medical Journal, Volume: 7 Issue: 3. https://ajindex.com/articles/1614172

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (27)

  1. Bala M, Catena F, Kashuk J, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World journal of emergency surgery: WJES. 2022;17(1):54.
  2. Sumbal R, Ali Baig MM, Sumbal A. Predictors of Mortality in Acute Mesenteric Ischemia: A Systematic Review and Meta-Analysis. The Journal of surgical research. 2022;275:72-86.
  3. Hou L, Wang T, Wang J, Zhao J. Outcomes of different acute mesenteric ischemia therapies in the last 20 years: A meta-analysis and systematic review. 2022;30(4):669-80.
  4. Lim S, Halandras PM, Bechara C, Aulivola B, Crisostomo P. Contemporary Management of Acute Mesenteric Ischemia in the Endovascular Era. Vascular and endovascular surgery. 2019;53(1):42-50.
  5. Zaman MN, Ali W, Dost W, et al. Endovascular Versus Open Surgical Approaches for Acute Mesenteric Ischemia: A Systematic Review of Outcomes. Cureus. 2025;17(5):e85013.
  6. Sakamoto T, Kubota T, Funakoshi H, Lefor AK. Multidisciplinary management of acute mesenteric ischemia: Surgery and endovascular intervention. World journal of gastrointestinal surgery. 2021;13(8):806-13.
  7. Chamseddine H, Halabi M, Hamdan H, et al. The impact of intervention timing, etiology, and revascularization strategy on acute mesenteric ischemia outcomes. Journal of vascular surgery. 2026;83(3):718-28.e4.
  8. Pedersoli F, Schönau K, Schulze-Hagen M, et al. Endovascular Revascularization with Stent Implantation in Patients with Acute Mesenteric Ischemia due to Acute Arterial Thrombosis: Clinical Outcome and Predictive Factors. Cardiovascular and interventional radiology. 2021;44(7):1030-8.
  9. Beaulieu RJ, Arnaoutakis KD, Abularrage CJ, Efron DT, Schneider E, Black JH, 3rd. Comparison of open and endovascular treatment of acute mesenteric ischemia. Journal of vascular surgery. 2014;59(1):159-64.
  10. Gries JJ, Sakamoto T, Chen B, Virk HUH, Alam M, Krittanawong C. Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review. Journal of Clinical Medicine. 2024;13(5):1217.
  11. Zientara A, Domenghino A-R, Schwegler I, et al. Interdisciplinary approach in emergency revascularization and treatment for acute mesenteric ischemia. BMC Surgery. 2021;21(1):89.
  12. Uludağ SS, Yurdacan M, Samancı C, Güreş N, Şanlı AN, Zengin AK. Which Treatment Should Be Chosen for Acute Arterial Mesenteric Ischemia? Surgery or Endovascular Intervention? Cerrahpaşa Medical Journal. 2022;46(1):12-6.
  13. Warren AS, Murphy B, Saldana-Ruiz N, Dansey K, Zettervall SL. Open Revascularization for Acute Mesenteric Ischemia is Associated with Increased Morbidity and Mortality when Compared to Endovascular Intervention. Annals of vascular surgery. 2025;111:386-92.
  14. Swerdlow NJ, Varkevisser RRB, Soden PA, Zettervall SL, McCallum JC, Li C, et al. Thirty-Day Outcomes After Open Revascularization for Acute Mesenteric Ischemia From the American College of Surgeons National Surgical Quality Improvement Program. Annals of vascular surgery. 2019;61:148-55.
  15. Habib SG, Semaan DB, Andraska EA, Madigan MC, Al-Khoury GE, Chaer RA, et al. A decade's experience with retrograde open mesenteric stenting for acute mesenteric ischemia. Journal of vascular surgery. 2024;80(3):831-7.
  16. Kundan M, Chebrolu H, Muniswamppa C, Kumar N, Chintamani, Varma V. Outcomes of Management of Patients with Acute Mesenteric Ischemia: A Prospective Study. Nigerian journal of surgery: official publication of the Nigerian Surgical Research Society. 2021;27(1):16-21.
  17. Alnaqi F, Alhamly H, Shehab H, Almesbahi N, Sadeq M, Alkandari B, et al. Survival outcomes following surgery for acute mesenteric ischemia: a retrospective cohort analysis: Word count: 2471. Langenbeck's archives of surgery. 2025;410(1):296.
  18. Vrba R, Řezáč T, Špička P, Klos D, Černá M, Köcher M. Acute mesenteric ischaemia in the elderly - results of combined endovascular and surgical treatment. Primary study. Scientific reports. 2025;15(1):74.
  19. Chen Y, Wang C, Tang Y, Ma M, Ma Q, Zhao Z, et al. Predictive factors for mortality in acute mesenteric ischemia. Frontiers in surgery. 2026;13:1805697.
  20. Ozturk S, Unver M, Ozdemir M, et al. Prognostic factors in acute mesenteric ischemia and evaluation with multiple logistic regression analysis effecting morbidity and mortality. Polish Journal of Surgery. 2021;93(1):25-33.
  21. Naazar AA, Omair A, Chu SH, Keane KG, Weber DG. A Shifting Trend Towards Endovascular Intervention in the Treatment of Acute Mesenteric Ischemia. Cureus. 2021;13(10):e18544.
  22. Isfordink CJ, Dekker D, Monkelbaan JF. Clinical value of serum lactate measurement in diagnosing acute mesenteric ischaemia. The Netherlands journal of medicine. 2018;76(2):60-4.
  23. Brillantino A, Iacobellis F, Renzi A, et al. Diagnostic value of arterial blood gas lactate concentration in the different forms of mesenteric ischemia. European journal of trauma and emergency surgery: official publication of the European Trauma Society. 2018;44(2):265-72.
  24. Bala M, Catena F, Kashuk J, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World journal of emergency surgery: WJES. 2022;17(1):54.
  25. Kundan M, Chebrolu H, Muniswamppa C, Kumar N, Chintamani, Varma V. Outcomes of Management of Patients with Acute Mesenteric Ischemia: A Prospective Study. Nigerian journal of surgery: official publication of the Nigerian Surgical Research Society. 2021;27(1):16-21.
  26. Alnaqi F, Alhamly H, Shehab H, Almesbahi N, Sadeq M, Alkandari B, et al. Survival outcomes following surgery for acute mesenteric ischemia: a retrospective cohort analysis: Word count: 2471. Langenbeck's archives of surgery. 2025;410(1):296.
  27. Brillantino A, Iacobellis F, Renzi A, et al. Diagnostic value of arterial blood gas lactate concentration in the different forms of mesenteric ischemia. European journal of trauma and emergency surgery: official publication of the European Trauma Society. 2018;44(2):265-72.