Outcomes and Predictors of Mortality in Acute Mesenteric Ischemia: A Prospective Study in a Yemeni Tertiary Hospital

Abstract Background: Acute mesenteric ischemia (AMI) is a critical vascular emergency with high mortality, often due to delayed diagnosis and intervention. This study aimed to evaluate the clinical outcomes and identify predictors of mortality among patients with AMI at a tertiary hospital in Sana'a, Yemen. Methods: We conducted a prospective observational study involving 31 patients diagnosed with AMI between August 2022 and February 2024 at Al Thawra Modern General Hospital. Data on demographics, clinical presentation, diagnostic methods, management strategies, and outcomes were collected. Statistical analysis was performed to identify factors associated with increased mortality. Results: The median age of the patients was 55.3 years, with a male predominance (67.7%). Severe abdominal pain was the most common presenting symptom (100%), followed by vomiting (77.4%) and nausea (64.5%). Arterial thrombosis was identified in 51.6% of the patients, and surgical intervention was performed in 80.6% of the patients. The overall mortality rate was 51.6%, with significant predictors of mortality, including delayed presentation (p < 0.01), heart failure (p = 0.02), and elevated white blood cell counts (p = 0.03). Conclusions: AMI continues to have a high mortality rate, particularly in resource-limited settings such as Yemen. Early diagnosis and timely surgical intervention are crucial for improving survival. Managing comorbidities such as heart failure and identifying high-risk patients early are essential to reduce mortality in AMI patients. Further studies are needed to explore strategies to improve early diagnosis and optimize treatment outcomes.