Abstract

Introduction: Acute mesenteric ischemia (AMI) is a critical condition with high mortality rates in intensive care units (ICUs). This study evaluated whether comorbidities, quantified using the Charlson Comorbidity Index (CCI), predict ICU and in-hospital mortality among patients with AMI.

Methods: A retrospective analysis was conducted on 183 AMI patients from the MIMIC-IV database (2008–2019). Comorbidities were assessed using CCI scores, and clinical severity was evaluated using the Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score II, and Logistic Organ Dysfunction Score. Logistic regression analyses identified predictors of mortality, and ROC curves determined optimal CCI cut-off values.

Results: The study included 183 patients (mean age 65.9 years; 50.8% male). A CCI cut-off ≥ 6 independently predicted increased ICU (aOR 3.44, 95% CI: 1.29–9.16; p = 0.013) and in-hospital mortality (aOR 3.44, 95% CI: 1.32–8.94; p = 0.011). Both CCI (continuous aOR 1.34, p = 0.005) and SOFA scores (aOR 1.27, p = 0.007)were independent predictors. Kaplan–Meier analyses confirmed significantly lower survival rates with CCI > 6 (p < 0.001).

Conclusion: The CCI effectively predicts ICU and in-hospital mortality in AMI patients, with a cut-off value of 6 serving as a practical threshold to guide early prognostication and clinical decision-making.