Mesenteric ischemia epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

The incidence rate of mesenteric ischemia secondary to superior mesenteric artery occlusion is 8.6/100 000/year. 70% of SMA occlusion is caused by embolism and 30% by thrombosis. The annual incidence of mesenteric ischemia is approximately 5.5% per 100,000 individuals. The incidence of mesenteric ischemia increases with age and the median age at diagnosis is 70 years. Mesenteric ischemia affects men and women equally.

Epidemiology and Demographics

Incidence

The incidence rate of mesenteric ischemia secondary to superior mesenteric artery occlusion is 8.6/100 000/year.
70% of SMA occlusion is caused by embolism and 30% by thrombosis.^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]
The annual incidence of mesenteric ischemia is approximately 5.5% per 100,000 individuals.
The incidence due to non-occlusive mesenteric ischemia is 2/100,000 persons and 1.8/100,000 per person due to mesenteric venous thrombosis.
In the United States, between 1995-2010 incidence of mesenteric ischemia declined from 8.4 to 6.7% per 100,000 individuals.
Between the year 1970 and 1982, in the population of Sweden, the incidence of mesenteric ischemia was estimated to be 12.9 cases per 100,000 individuals.

Prevalence

The prevalence of mesenteric ischemia:^[9]
- Occlusive mesenteric ischemia due to mesenteric venous thrombosis is approximately per 100,000 individuals worldwide.
- Non-occlusive mesenteric ischemia is approximately 6000 per 100,000 individuals worldwide.

Case-fatality rate/Mortality rate

In 2017, the incidence of mesenteric ischemia is approximately 90-200 per 100,000 of all the surgical admissions with a mortality rate of 50%.^[10]

Age

The incidence of mesenteric ischemia increases with age and the median age at diagnosis is 70 years.^[11]
Mesenteric ischemia commonly affects individuals older than 60 years of age, a few cases are reported in their 20s. Younger age group having risk factors such as atrial fibrillation or other hypercoagulable states such as protein C and protein S deficiency are also predisposed to the risk.

Race

There is no racial predilection to mesenteric ischemia.
Mesenteric ischemia usually affects individuals of the African american race because of their higher predilection towards developing atherosclerosis.

Gender

Mesenteric ischemia is more prevalent in women as compared to males.^[12]

Region

The majority of mesenteric ischemia cases are reported in Sweden.

References

↑ Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M (2004). “Incidence of acute thrombo-embolic occlusion of the superior mesenteric artery–a population-based study”. Eur J Vasc Endovasc Surg. 27 (2): 145–50. doi:10.1016/j.ejvs.2003.11.003. PMID 14718895.
↑ Acosta S (2010). “Epidemiology of mesenteric vascular disease: clinical implications”. Semin Vasc Surg. 23 (1): 4–8. doi:10.1053/j.semvascsurg.2009.12.001. PMID 20298944.
↑ Jrvinen O, Laurikka J, Salenius JP, Tarkka M (1994). “Acute intestinal ischaemia. A review of 214 cases”. Ann Chir Gynaecol. 83 (1): 22–5. PMID 8053632.
↑ Acosta, S.; Ögren, M.; Sternby, N.-H.; Bergqvist, D.; Björck, M. (2004). “Incidence of Acute Thrombo-Embolic Occlusion of the Superior Mesenteric Artery—A Population-based Study”. European Journal of Vascular and Endovascular Surgery. 27 (2): 145–150. doi:10.1016/j.ejvs.2003.11.003. ISSN 1078-5884.
↑ Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M (2006). “Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors”. J Intern Med. 259 (3): 305–13. doi:10.1111/j.1365-2796.2006.01613.x. PMID 16476108.
↑ Acosta S (2010). “Epidemiology of mesenteric vascular disease: clinical implications”. Semin Vasc Surg. 23 (1): 4–8. doi:10.1053/j.semvascsurg.2009.12.001. PMID 20298944 : 20298944 Check |pmid= value (help).
↑ Acosta S, Alhadad A, Svensson P, Ekberg O (2008). “Epidemiology, risk and prognostic factors in mesenteric venous thrombosis”. Br J Surg. 95 (10): 1245–51. doi:10.1002/bjs.6319. PMID 18720461.
↑ Kärkkäinen, Jussi M.; Acosta, Stefan (2017). “Acute mesenteric ischemia (part I) – Incidence, etiologies, and how to improve early diagnosis”. Best Practice & Research Clinical Gastroenterology. 31 (1): 15–25. doi:10.1016/j.bpg.2016.10.018. ISSN 1521-6918.
↑ Kärkkäinen JM, Acosta S (2017). “Acute mesenteric ischemia (part I) – Incidence, etiologies, and how to improve early diagnosis”. Best Pract Res Clin Gastroenterol. 31 (1): 15–25. doi:10.1016/j.bpg.2016.10.018. PMID 28395784.
↑ Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA; et al. (2017). “Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery”. World J Emerg Surg. 12: 38. doi:10.1186/s13017-017-0150-5. PMC 5545843. PMID 28794797.
↑ Huang, Hsien-Hao; Chang, Yu-Che; Yen, David Hung-Tsang; Kao, Wei-Fong; Chen, Jen-Dar; Wang, Lee-Min; Huang, Chun-I; Lee, Chen-Hsen (2005). “Clinical Factors and Outcomes in Patients with Acute Mesenteric Ischemia in the Emergency Department”. Journal of the Chinese Medical Association. 68 (7): 299–306. doi:10.1016/S1726-4901(09)70165-0. ISSN 1726-4901.
↑ Veenstra RP, ter Steege RW, Geelkerken RH, Huisman AB, Kolkman JJ (2012). “The cardiovascular risk profile of atherosclerotic gastrointestinal ischemia is different from other vascular beds”. Am J Med. 125 (4): 394–8. doi:10.1016/j.amjmed.2011.09.013. PMID 22305578.

[pmid14718895-1] Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M (2004). “Incidence of acute thrombo-embolic occlusion of the superior mesenteric artery–a population-based study”. Eur J Vasc Endovasc Surg. 27 (2): 145–50. doi:10.1016/j.ejvs.2003.11.003. PMID 14718895.

[pmid20298944-2] Acosta S (2010). “Epidemiology of mesenteric vascular disease: clinical implications”. Semin Vasc Surg. 23 (1): 4–8. doi:10.1053/j.semvascsurg.2009.12.001. PMID 20298944.

[pmid8053632-3] Jrvinen O, Laurikka J, Salenius JP, Tarkka M (1994). “Acute intestinal ischaemia. A review of 214 cases”. Ann Chir Gynaecol. 83 (1): 22–5. PMID 8053632.

[AcostaÖgren2004-4] Acosta, S.; Ögren, M.; Sternby, N.-H.; Bergqvist, D.; Björck, M. (2004). “Incidence of Acute Thrombo-Embolic Occlusion of the Superior Mesenteric Artery—A Population-based Study”. European Journal of Vascular and Endovascular Surgery. 27 (2): 145–150. doi:10.1016/j.ejvs.2003.11.003. ISSN 1078-5884.

[pmid16476108-5] Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M (2006). “Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors”. J Intern Med. 259 (3): 305–13. doi:10.1111/j.1365-2796.2006.01613.x. PMID 16476108.

[pmid:_20298944-6] Acosta S (2010). “Epidemiology of mesenteric vascular disease: clinical implications”. Semin Vasc Surg. 23 (1): 4–8. doi:10.1053/j.semvascsurg.2009.12.001. PMID 20298944 : 20298944 Check |pmid= value (help).

[pmid18720461-7] Acosta S, Alhadad A, Svensson P, Ekberg O (2008). “Epidemiology, risk and prognostic factors in mesenteric venous thrombosis”. Br J Surg. 95 (10): 1245–51. doi:10.1002/bjs.6319. PMID 18720461.

[KärkkäinenAcosta2017-8] Kärkkäinen, Jussi M.; Acosta, Stefan (2017). “Acute mesenteric ischemia (part I) – Incidence, etiologies, and how to improve early diagnosis”. Best Practice & Research Clinical Gastroenterology. 31 (1): 15–25. doi:10.1016/j.bpg.2016.10.018. ISSN 1521-6918.

[pmid28395784-9] Kärkkäinen JM, Acosta S (2017). “Acute mesenteric ischemia (part I) – Incidence, etiologies, and how to improve early diagnosis”. Best Pract Res Clin Gastroenterol. 31 (1): 15–25. doi:10.1016/j.bpg.2016.10.018. PMID 28395784.

[pmid28794797-10] Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA; et al. (2017). “Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery”. World J Emerg Surg. 12: 38. doi:10.1186/s13017-017-0150-5. PMC 5545843. PMID 28794797.

[HuangChang2005-11] Huang, Hsien-Hao; Chang, Yu-Che; Yen, David Hung-Tsang; Kao, Wei-Fong; Chen, Jen-Dar; Wang, Lee-Min; Huang, Chun-I; Lee, Chen-Hsen (2005). “Clinical Factors and Outcomes in Patients with Acute Mesenteric Ischemia in the Emergency Department”. Journal of the Chinese Medical Association. 68 (7): 299–306. doi:10.1016/S1726-4901(09)70165-0. ISSN 1726-4901.

[pmid22305578-12] Veenstra RP, ter Steege RW, Geelkerken RH, Huisman AB, Kolkman JJ (2012). “The cardiovascular risk profile of atherosclerotic gastrointestinal ischemia is different from other vascular beds”. Am J Med. 125 (4): 394–8. doi:10.1016/j.amjmed.2011.09.013. PMID 22305578.

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