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Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases

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An Erratum to this article was published on 12 March 2015



In the intensive care unit (ICU), the outcomes of patients with acute mesenteric ischemia (AMI) are poorly documented. This study aimed to determine the risk factors for death in ICU patients with AMI.


A retrospective, observational, non-interventional, multicenter study was conducted in 43 ICUs of 38 public institutions in France. From January 2008 to December 2013, all adult patients with a diagnosis of AMI during their hospitalization in ICU were included in a database. The diagnosis was confirmed by at least one of three procedures (computed tomography scan, gastrointestinal endoscopy, or upon surgery). To determine factors associated with ICU death, we established a logistic regression model. Recursive partitioning analysis was applied to construct a decision tree regarding risk factors and their interactions most critical to determining outcomes.


The death rate of the 780 included patients was 58 %. Being older, having a higher sequential organ failure assessment (SOFA) severity score at diagnosis, and a plasma lactate concentration over 2.7 mmol/l at diagnosis were independent risk factors of ICU mortality. In contrast, having a prior history of peripheral vascular disease or an initial surgical treatment were independent protective factors against ICU mortality. Using age and SOFA severity score, we established an ICU mortality score at diagnosis based on the cutoffs provided by recursive partitioning analysis. Probability of survival was statistically different (p < 0.001) between patients with a score from 0 to 2 and those with a score of 3 and 4.


Acute mesenteric ischemia in ICU patients was associated with a 58 % ICU death rate. Age and SOFA severity score at diagnosis were risk factors for mortality. Plasma lactate concentration over 2.7 mmol/l was also an independent risk factor, but values in the normal range did not exclude the diagnosis of AMI.

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The authors have no conflict of interest to disclose related to this topic.

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Correspondence to Marc Leone.

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Take-home message: Acute mesenteric ischemia was associated with a 58 % death rate in ICU patients. Age and severity score at diagnosis were risk factors for mortality; plasma lactate concentration above 2.7 mmol/l was also an independent risk factor.

For the AtlanRea and AzuRea Collaborative Network Investigators; members are listed in the “Appendix”.

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Appendix: List of investigators

Appendix: List of investigators

Pierre Asfar, Johan Auchabie (Hôpital Universitaire d’Angers), Gaston Grossmith (Centre Hospitalier Edmond Garcin, Aubagne), Pierre Courant (Centre Hospitalier d’Avignon), Jean-Luc Fellahi (Centre Hospitalo-Universitaire de Caen), Mélanie Tari, Bertrand Souweine (Centre Hospitalier de Clermont Ferrand), Pierre Visintini (Centre Hospitalier Interrégional des Alpes du Sud, Gap), Tarek Sharshar (Hôpital Raymond Poincaré, Montigny le Bretonneux), Vincent Piriou (Hospices Civils de Lyon), Djamel Mokart (Institut Paoli-Calmettes, Marseille), Sandrine Wiramus, Jacques Albanèse (Hôpital la Conception, Marseille), Alexandre Marillier, Nicolas Bruder (Hôpital la Timone, Marseille), Sami Hraiech, Laurent Papazian (Réanimation DRIS, Hôpital Nord, Marseille), Claire Contargyris (Hôpital Laveran, Marseille), Xavier Capdevila (Hôpital Lapeyronie, Montpellier), Julien Darmian (CHU Nancy Hôpital Central), Loubna Elotmani (Hôpital Carremeau, Nîmes), Thierry Boulain (Hôpital de la Source, Orléans), Philippe Montravers (Hôpital Bichat, Paris), Jean-Paul Mira, Frédéric Pene (Hôpital Cochin, Paris), Olivier Langeron (Hôpital la Pitié Salpétrière, Paris), Matthieu Legrand (Hôpital Saint Louis, Paris), Dorothé Balayn, Sabrina Seguin (CHU de Poitiers), Ali Mofredj (Centre Hospitalier de Salon), Marie-Charlotte Vogler, Serge Molliex (CHU Saint Etienne), Olivier Fourcade, Thomas Geeraerts (CHU Toulouse).

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Leone, M., Bechis, C., Baumstarck, K. et al. Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases. Intensive Care Med 41, 667–676 (2015).

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