Treatment of acute mesenteric ischemia between 2010 and 2020 – a German nation-wide study
Open accessAbstract
Background: Aim of this study was to analyze long-term trends of hospitalizations, treatment regimen and in-hospital mortality of in-patients with acute mesenteric ischemia (AMI) over the past decade and effects of the SARS-CoV2-pandemic. Methods: We analyzed fully anonymized data from the German Federal Statistical Office of patients with AMI between 2010 and 2020. Besides descriptive analyses of age, gender, in-hospital mortality, comorbidity burden and treatment regimen, multivariable logistic regression analyses were performed to identify independent variables associated with in-hospital mortality and different treatment. Results: A total of 278,121 hospitalizations (120,667 male [43.4%], mean age 72.1 years) with AMI were included in this study. The total number of hospitalizations increased from 2010 ( n = 24,172) to 2019 ( n = 26,684) (relative increase 10.4%). In-hospital mortality decreased over the past decade from 36.6% to 2010 to 31.1% in 2019 (rel. decrease 15.2%). Independent risk factors for in-hospital mortality were older age (OR = 1.03 per year), higher comorbidity burden (OR = 1.06 per point in van Walraven score [vWs]), male gender (OR = 1.07), AMI as a secondary diagnosis (OR = 1.44), and the need for surgical (visceral surgery: OR = 1.38, vascular surgery: OR = 3.33) and endovascular treatment (OR = 1.21). We report a decline in hospitalizations during the first wave of infection in spring 2020 (rel. decrease 9.7%). Conclusion: In-hospital mortality rate has declined over the past decade, but remains high at above 30%. Older age, increased comorbidity and male gender are independent factors for in-hospital mortality. Hospitalizations requiring vascular surgery are associated with high in-hospital mortality, followed by visceral surgery and endovascular approaches. The first wave of the SARS-CoV2-pandemic in spring 2020 implied a decrease in hospital admissions.
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Visceral surgery has been preferred especially in patients with high risks of complications such as bowel ischemia, perforation, or peritonitis.
“visceral surgery has been preferred, especially in patients with high risks of complications, such as bowel ischemia, perforation, or peritonitis, and has therefore been associated with higher mortality rates [61].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [61]
The Discussion says visceral surgery might be preferentially performed in patients with bowel ischemia, perforation, or peritonitis. The citing sentence presents that proposed explanation as an established preference, although the paper says its data lack clinical information on disease stage and severity. The Discussion also associates more advanced disease and the need for intervention with higher mortality. (LLM, conf=0.86)
Experimental — accuracy not yet measuredVisceral surgery has been associated with higher mortality rates.
“visceral surgery has been preferred, especially in patients with high risks of complications, such as bowel ischemia, perforation, or peritonitis, and has therefore been associated with higher mortality rates [61].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [61]
The Conclusions report that hospitalizations involving visceral surgery were associated with higher in-hospital mortality than those involving endovascular approaches. The Discussion suggests that visceral surgery might be preferentially performed in patients with complications such as bowel ischemia, perforation, or peritonitis, and that more advanced disease may explain higher mortality. The citing sentence presents that tentative explanation as an established causal relationship. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn most patients who undergo mechanical interventions for acute mesenteric ischemia in Germany, visceral surgery is preferred over endovascular interventions by a large margin.
“In most patients who undergo mechanical interventions, visceral surgery is preferred over endovascular interventions by a large margin [61].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [61]
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- Authors
- Bette, S., Habeeballah, O., Luitjens, J. H., Kroencke, T., Scheurig-Muenkler, C., & Decker, J. A.
- Affiliations
- University of Augsburg (DE)
- Venue
- BMC Gastroenterology
- Published
- 2023-09-06
- Volume
- 23
- Issue
- 1
- Pages
- 300-300
- ISSN
- 1471-230X (ISSN-L)
- PMC
- PMC10481516
- OpenAlex
- W4386482232
- Cited by
- 15
- References
- 44
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 3
- FWCI
- 4.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Gastroenterology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- OPUS (Augsburg University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Universität Augsburg
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- acute mesenteric ischemia, in-hospital mortality, hospitalization trends, COVID-19 pandemic, risk factors, comorbidity burden, vascular surgery, visceral surgery, endovascular treatment, secondary diagnoses, age and sex differences
- MeSH terms
- COVID-19, SARS-CoV-2, Aged, Humans, Male, RNA, Viral, Hospital Mortality, Mesenteric Ischemia
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