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Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors.

Acosta, Stefan LU ; Ögren, M; Sternby, Nils LU ; Bergqvist, D and Bjorck, M (2006) In Journal of Internal Medicine 259(3). p.305-313
Abstract
To estimate the incidence and extension of visceral organ infarction, and to evaluate potential causes, in patients with autopsy-verified nonocclusive mesenteric ischaemia (NOMI) and transmural intestinal infarction. In Malmo, Sweden, the autopsy rate between 1970 and 1982 was 87%, creating possibilities for a population-based study. Amongst 23 446 clinical autopsies, 997 cases were coded for intestinal ischaemia in a database. In addition, 7569 forensic autopsy protocols were analysed. In a nested case-control study within the clinical autopsy cohort, four NOMI-free controls, matched for gender, age at death and year of death, were identified for each fatal NOMI case to evaluate risk factors. The overall incidence of autopsy-verified... (More)
To estimate the incidence and extension of visceral organ infarction, and to evaluate potential causes, in patients with autopsy-verified nonocclusive mesenteric ischaemia (NOMI) and transmural intestinal infarction. In Malmo, Sweden, the autopsy rate between 1970 and 1982 was 87%, creating possibilities for a population-based study. Amongst 23 446 clinical autopsies, 997 cases were coded for intestinal ischaemia in a database. In addition, 7569 forensic autopsy protocols were analysed. In a nested case-control study within the clinical autopsy cohort, four NOMI-free controls, matched for gender, age at death and year of death, were identified for each fatal NOMI case to evaluate risk factors. The overall incidence of autopsy-verified fatal NOMI was 2.0/100 000 person-years, increasing with age up to 40/100 000 person-years in octogenarians. Patients with stenosis of the superior mesenteric artery (SMA; n = 25) were older (P = 0.002) than those without (n = 37), and had more often a concomitant stenosis of the coeliac trunk (P < 0.001). Synchronous infarction in the liver, spleen or kidney occurred in one-fifth of all patients. Fatal cardiac failure [OR 2.9 (1.7-5.2)], history of atrial fibrillation [OR 2.2 (1.2-4.0)] and recent surgery [OR 3.4 (1.6-6.9)] were risk factors for fatal NOMI. Fatal heart failure was the leading cause of intestinal hypoperfusion, although stenosis of the SMA and coeliac trunk, atrial fibrillation and recent surgery contributed significantly. Collaboration across specialties seems to be of utmost importance to improve the prognosis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
incidence, risk factors, nonocclusive mesenteric ischaemia
in
Journal of Internal Medicine
volume
259
issue
3
pages
305 - 313
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • wos:000235258900008
  • pmid:16476108
  • scopus:33645109669
ISSN
1365-2796
DOI
10.1111/j.1365-2796.2006.01613.x
language
English
LU publication?
yes
id
02deb290-9e19-4447-9f24-e3177460ff34 (old id 153515)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16476108&dopt=Abstract
date added to LUP
2007-07-04 16:22:14
date last changed
2019-10-15 05:02:08
@article{02deb290-9e19-4447-9f24-e3177460ff34,
  abstract     = {To estimate the incidence and extension of visceral organ infarction, and to evaluate potential causes, in patients with autopsy-verified nonocclusive mesenteric ischaemia (NOMI) and transmural intestinal infarction. In Malmo, Sweden, the autopsy rate between 1970 and 1982 was 87%, creating possibilities for a population-based study. Amongst 23 446 clinical autopsies, 997 cases were coded for intestinal ischaemia in a database. In addition, 7569 forensic autopsy protocols were analysed. In a nested case-control study within the clinical autopsy cohort, four NOMI-free controls, matched for gender, age at death and year of death, were identified for each fatal NOMI case to evaluate risk factors. The overall incidence of autopsy-verified fatal NOMI was 2.0/100 000 person-years, increasing with age up to 40/100 000 person-years in octogenarians. Patients with stenosis of the superior mesenteric artery (SMA; n = 25) were older (P = 0.002) than those without (n = 37), and had more often a concomitant stenosis of the coeliac trunk (P &lt; 0.001). Synchronous infarction in the liver, spleen or kidney occurred in one-fifth of all patients. Fatal cardiac failure [OR 2.9 (1.7-5.2)], history of atrial fibrillation [OR 2.2 (1.2-4.0)] and recent surgery [OR 3.4 (1.6-6.9)] were risk factors for fatal NOMI. Fatal heart failure was the leading cause of intestinal hypoperfusion, although stenosis of the SMA and coeliac trunk, atrial fibrillation and recent surgery contributed significantly. Collaboration across specialties seems to be of utmost importance to improve the prognosis.},
  author       = {Acosta, Stefan and Ögren, M and Sternby, Nils and Bergqvist, D and Bjorck, M},
  issn         = {1365-2796},
  keyword      = {incidence,risk factors,nonocclusive mesenteric ischaemia},
  language     = {eng},
  number       = {3},
  pages        = {305--313},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Journal of Internal Medicine},
  title        = {Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors.},
  url          = {http://dx.doi.org/10.1111/j.1365-2796.2006.01613.x},
  volume       = {259},
  year         = {2006},
}