Abstract: The aim of this paper is to synthesize research findings on the risk factors for the development of mesenteric ischemia and the clinical, laboratory, and radiological predictors of mortality and intestinal necrosis in affected patients. The review utilises 120 references. The evidence map suggests that mesenteric ischemia risk and prognosis are dominated by a recurring triad of systemic vulnerability, hemodynamic compromise, and markers of advanced bowel injury. Among the clearest signals, lactate thresholds above 2–3 mmol/L, SOFA values in higher ranges, and older age were repeatedly associated with intestinal necrosis and death, with reported effect sizes reaching OR 49.66 for lactate >2 mmol/L in one cohort and OR 23.3 for SOFA ≥10 in NOMI-focused work. The mapped literature also consistently indicates that cardiovascular disease, renal dysfunction, vasopressor exposure, dialysis-related hypotension, and recent cardiac or aortic surgery define particularly high-risk settings, while CT findings such as decreased bowel wall enhancement, bowel dilation, pneumatosis, and ascites identify patients who may already have irreversible transmural injury. Clinically, these patterns support a low threshold for urgent CTA, serial metabolic monitoring, and rapid escalation to revascularization or surgery when high-risk clinical and radiologic features converge. Although the overall evidence remains heterogeneous and largely observational, it strongly highlights the practical value of early recognition and structured risk stratification. Future research should prioritize prospective, subtype-specific models that integrate bedside findings, laboratory markers, and imaging features to better distinguish reversible ischemia from irreversible necrosis and to guide timing of intervention.
Final search date and database lock: 2026-03-30 22:14:34 CEST
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Total Abstracts/Papers: 459
Downloaded Abstracts/Papers: 459
Included original and non-original Abstracts/Papers (all): 220
Included original Abstracts/Papers (Vote counting by direction of effect): 213
Reference Index (links used in paper): 120
Total participants (topic deduplicated ΣN): 1362960
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Reference Index (120)
[1] Anticoagulation management and outcomes in critically ill patients with acute mesenteric ischemia: an international study. — https://doi.org/10.1007/s00134-025-07980-4
[12] Preoperative Risk Factors for Short-Term Postoperative Mortality of Acute Mesenteric Ischemia after Laparotomy: A Systematic Review and Meta-Analysis. — https://doi.org/10.1155/2020/1382475
[21] The preoperative SOFA score and remnant small intestine length are postoperative risk factors for mortality in patients with non-occlusive mesenteric ischemia: a case-control study. — https://doi.org/10.1002/ams2.821
[22] Incidence of contrast-induced acute kidney injury in patients with acute mesenteric ischemia and identification of potential predictive factors. — https://doi.org/10.1177/17085381211050766
[23] Clinical Features and Factors Affecting Postoperative Mortality for Obstructive Acute Mesenteric Ischemia in China: A Hospital- Based Survey. — https://doi.org/10.2147/vhrm.s261167
[36] Non-occlusive mesenteric ischemia in chronically dialyzed patients: a disease with multiple risk factors. — https://doi.org/10.1159/000086346
[37] Results after intraoperative open and endovascular revascularization of acute mesenteric ischemia requiring a laparotomy. — https://doi.org/10.1007/s00423-023-03035-8
[38] The Relationship between Intradialytic Hypotension and Hospitalized Mesenteric Ischemia: A Case-Control Study. — https://doi.org/10.2215/cjn.13891217
[40] Risk factors of geriatrics index of comorbidity and MDCT findings for predicting mortality in patients with acute mesenteric ischemia due to superior mesenteric artery thromboembolism. — https://doi.org/10.1259/bjr.20190605
[48] Percutaneous mechanical thrombectomy versus catheter-directed thrombolysis for the treatment of arterial acute mesenteric ischemia and risk factors for 30-day mortality. — https://doi.org/10.3389/fcvm.2025.1553170
[50] Mesenteric venous thrombosis and factors associated with mortality: a statistical analysis with five-year follow-up. — https://doi.org/10.1007/s11605-009-0833-7
[51] Predictive Factors of Intestinal Necrosis in Acute Mesenteric Ischemia: Prospective Study from an Intestinal Stroke Center. — https://doi.org/10.1038/ajg.2017.38
[52] The psoas muscle density as a predictor of postoperative complications and 30-day mortality for acute mesenteric ischemia patients. — https://doi.org/10.1007/s00261-020-02714-0
[57] Preoperative prognostic predictors and treatment strategies for surgical procedure focused on the sequential organ failure assessment score in nonocclusive mesenteric ischemia: a multicenter retrospective cohort study. — https://doi.org/10.1097/js9.0000000000000733
[58] Role of Platelet to Lymphocyte Ratio and Red Cell Distribution Width in Predicting Postoperative Complications in Patients with Acute Mesenteric Ischemia. — https://doi.org/10.1016/j.avsg.2022.01.036
[59] Role of Frailty and Comorbidity Status in Predicting Morbidity and Mortality in Patients with Acute Mesenteric Ischemia. — https://doi.org/10.1016/j.avsg.2020.03.037
[62] Clinical Features and Outcomes of Patients With Acute Mesenteric Ischemia and Concomitant Colon Ischemia: A Retrospective Cohort Study. — https://doi.org/10.1016/j.jss.2018.08.010
[66] Effective new predictors of prognosis and comparison of multidisciplinary treatment options in acute mesenteric ischemia. — https://doi.org/10.14744/nci.2023.82231
[67] Prognosis of critically ill patients with occlusive arterial acute mesenteric ischemia: the 5-year French experience of a dedicated mesenteric stroke center SURVI. — https://doi.org/10.1016/j.accpm.2025.101650
[77] A Comprehensive Way to Access Hospital Death Prediction Model for Acute Mesenteric Ischemia: A Combination of Traditional Statistics and Machine Learning. — https://doi.org/10.2147/ijgm.s300492
[84] Irreversible Transmural Intestinal Necrosis in Acute Mesenteric Ischemia: Retrospective Cohort Study from a High-Volume Hospital. — https://doi.org/10.1089/lap.2024.0016
[85] Risk factors for ischemic gastrointestinal complications in patients undergoing open cardiac surgical procedures: A single-center retrospective experience. — https://doi.org/10.1111/jocs.16294
[89] Improving clinical suspicion of acute mesenteric ischemia among patients with acute abdomen: a cross-sectional study from an intestinal stroke center. — https://doi.org/10.1186/s13017-023-00505-8
[97] The value of serial serum lactate measurements in predicting the extent of ischemic bowel and outcome of patients suffering acute mesenteric ischemia. — https://doi.org/10.1007/s11605-015-2752-0
[104] Hypercoagulability status, operative mortality, and long-term survival in patients operated on for mesenteric venous thrombosis. — https://doi.org/10.1016/j.jvsv.2023.02.006
[108] Relationship of superior mesenteric artery thrombus density with transmural intestinal necrosis on multidetector computed tomography in acute mesenteric ischemia. — https://doi.org/10.21037/qims-20-604
[109] Impact of etiologic factors and APACHE II and POSSUM scores in management and clinical outcome of acute intestinal ischemic disorders after surgical treatment. — https://doi.org/10.1007/s00268-005-0716-3
[111] Outcome Comparison of Endovascular and Open Surgery for the Treatment of Acute Superior Mesenteric Artery Embolism: A Retrospective Study. — https://doi.org/10.3389/fsurg.2022.833464
[118] Factors associated with the need for long-term total parenteral nutrition in survivors of acute superior mesenteric artery occlusion. — https://doi.org/10.1007/s00068-023-02281-1
[121] Mesenteric ischemia in patients with end-stage renal disease: a nationwide longitudinal study. — https://doi.org/10.1159/000338451
[142] Nomogram for predicting transmural bowel infarction in patients with acute superior mesenteric venous thrombosis. — https://doi.org/10.3748/wjg.v26.i26.3800
[143] Coronary artery disease and mesenteric artery stenosis - Two sides of the same coin? - Long term prospective analysis. — https://doi.org/10.5582/irdr.2019.01087
[145] Morphologic characteristics and endovascular management of acute type B dissection patients with superior mesenteric artery involvement. — https://doi.org/10.1016/j.jvs.2020.12.099
[166] Management of acute aortoiliac arterial thrombosis in patients with the novel coronavirus disease 2019: A case series and systematic review of the literature. — https://doi.org/10.1016/j.avsurg.2022.100105
[185] Thirty-Day Outcomes After Open Revascularization for Acute Mesenteric Ischemia From the American College of Surgeons National Surgical Quality Improvement Program. — https://doi.org/10.1016/j.avsg.2019.05.024
[192] Effect of Clinical Suspicion by Referral Physician and Early Outcomes in Patients with Acute Superior Mesenteric Artery Embolism. — https://doi.org/10.5758/vsi.2017.33.3.99
[195] Clinical profiles and outcomes of acute type B aortic dissection in the current era: lessons from the International Registry of Aortic Dissection (IRAD). — https://doi.org/10.1161/01.cir.0000087386.07204.09
[197] Contemporary results of surgery in acute type A aortic dissection: The International Registry of Acute Aortic Dissection experience. — https://doi.org/10.1016/j.jtcvs.2004.09.005
[200] Diagnostic value of dual-energy computed tomography in irreversible transmural intestinal necrosis in patients with acute occlusive mesenteric ischemia. — https://doi.org/10.4240/wjgs.v17.i7.105956
[201] Outcomes of revascularized acute mesenteric ischemia in the American College of Surgeons National Surgical Quality Improvement Program database. — https://doi.org/10.1177/000313481107700715
[210] Significance of malperfusion syndromes prior to contemporary surgical repair for acute type A dissection: outcomes and need for additional revascularizations. — https://doi.org/10.1016/j.ejcts.2007.04.012
[212] Impact of Preoperative Anemia and Postoperative Hemoglobin Drop on the Incidence of Acute Kidney Injury and In-Hospital Mortality in Patients With Type B Acute Aortic Syndromes Undergoing Thoracic Endovascular Aortic Repair. — https://doi.org/10.1177/1538574417697211
[216] Enoxaparin for primary thromboprophylaxis in ambulatory patients with coronavirus disease-2019 (the OVID study): a structured summary of a study protocol for a randomized controlled trial. — https://doi.org/10.1186/s13063-020-04678-4
