Determinants of in-hospital mortality and length of stay for acute intestinal gangrene

Background: Intestinal gangrene carries high operative mortality and morbidity rates. This study was undertaken to identify predictors of in-hospital death and length of stay. Methods: Retrospective review of hospital data over a 6-year period identified 107 patients diagnosed with acute bowel gangrene. Results: Among the baseline factors that had a significant univariable association with mortality (51%) were age (P = 0.04), symptom duration (P = 0.01), preoperative and postoperative pH and lactic acid (P less than or equal to 0.02), history of hypertension (P = 0.001), and renal failure (P = 0.008). Symptom duration and history of hypertension were independent risk factors for mortality. Longer length of stay was univariably associated with symptom duration (P = 0.006), systemic acidosis (P less than or equal to 0.005), vascular etiology (P = 0.04), amount of resected bowel (P = 0.001), and need for second-look procedures (P < 0.001). Conclusions: The presence of multiple risk factors predictive of a high mortality rate may aid more realistic decision making for physicians, patients, and family members. (C) 2004 Excerpta Medica, Inc. All rights reserved.